Intermittent catheterisation in children September 2016 8. The following steps may vary if using a coated (a) or non-coated (b) catheter: (a) If using a pre-lubricated ready to use catheter, open the package and hang the package beside the patient (a) When using a catheter with a lubricating bag or bag of liquid in the package active coating according to manufacturer’s guidelines and hang the package with the catheter inside beside the patient. (b) When using a catheter without coating, open the catheter package and lubricating gel To activate the coating of the catheter. To activate the coating of the catheter. 9. If using a drainage bag connect drainage bag to the catheter. To reduce the risk of cross-infection. 10. Remove cover that is maintaining the patient's privacy, and position a disposable pad under the patient's buttocks and thighs. To ensure urine does not leak onto the bed. 11. Place the receptacle between the patient's legs (if a receptacle is used). 12. Lift the penis and retract the foreskin using a gauze swab and cleanse the glans penis with the wet swabs. Begin with the foreskin, then the glans, and finally the urethral meatus. To prevent infection. 13. Steps 12, 13 and 14 refer to situation (b) (non-lubricated catheter) only. (b) If anaesthetic gel is to be used. Apply some gel on the meatus, insert the cone of the lubricant syringe. Then instil 10-15 ml of the (anaesthetic) lubricating gel slowly into the urethra while holding the penis firmly below the glans with the thumb and fingers, and the syringe firmly onto the meatus to prevent the gel from leaking out. Adequate lubrication helps to prevent urethral trauma. Use of a local anaesthetic minimises the discomfort experienced by the patient, and can aid success of the procedure. 14. (b) Remove the syringe from the urethra and hold the penis upright and closed so that the gel stays in the urethra. 15. (b) Wait in case of anaesthetic lubrication as recommended on the product (3-5 min.). To ensure maximised anaesthetic effect 16. Replace existing gloves with a sterile pair. To prevent infection. 17. Hold the penis with one hand and the catheter with the other hand (wearing sterile glove). To prevent infection. Lift the penis at a 90-degree angle to the body. Insert the catheter in the meatus and advance to the point at which you feel resistance. Then place the penis in a horizontal position and advance the catheter further into the urethra until urine drains. Then insert the catheter at least 2 cm deeper Lifting the penis straightens the penile urethra and facilitates catheterisation. To be sure that the catheter is in the bladder.
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