Nurses perform this highly skilled procedure with the least amount of difficulty in the hospital and community settings. In the right circumstances it prevents many complications and saves lives.
Equipment needed to insert an indwelling Foley Catheter
When a patient is unable to pass water due to any reason it may become necessary to insert an “in & out” catheterization or place an indwelling catheter. This procedure requires specialized knowledge, sterile equipment and a Nurse who is trained to do this procedure aseptically.
The following is a list of equipment which is needed most of the time. It is not an exhaustive list. When complications arise, the nurse must abandon the procedure so that no harm occurs to the patient as a result of unsuccessful attempts.
A surgeon or Urology Specialist has more experience, legal authority and skill to perform this procedure when there are complications. The following equipment is usually set up on a cleaned trolley.
Catheterization Pack with the following equipment
Foley catheter (appropriate size, Size FG 12 for an adult patient) is considered normal. If the patient has had multiple catheterizations and is bleeding in the bladder, use a larger catheter.
Lignocaine gel, one tube
Two 10 ml. syringes.
One 10 cc syringe manufactured by Nipro. Photographer: Sarjeet S. Gill
Sterile drape with a hole in the center
An ampule of normal saline or chlorohexidine. According to institutional policy.
An ampule of sterile water for injection into bubble
Sterile forceps or sterile gloves or both. Practitioners choice.
Drainage bag with urometer if the urine is to be measured each hour
Drainage bag stand or bed attachment to hang the urine drainage bag
Valid consent of patient or legal guardian of patient
Picture 2. Two Foley Catheters. Picture by Sarjeet S. Gill
All the equipment must be set up before gloving up if the procedure is to be performed by one person. If an assistant is available then the assistant will be able to open and drop items on the sterile field.
Insertion of an indwelling catheter is a mildly painful procedure. If an assistant is available then it is best for the assistant to hold the patients hand and comfort him/her.
The catheterization trolley is usually set up as is shown in the picture below.