- Types of Catheters & Key Use
- Indwelling (Foley): Most common; for retention/monitoring. Highest CAUTI risk.
- Intermittent (“Straight”): Preferred for neurogenic bladder. Lower infection risk.
- External (Condom): For incontinence without retention. Lowest infection risk.
- Suprapubic: Long-term use or when urethra is impassable (e.g., trauma).
- Coudé Tip: Curved tip specifically for navigating an enlarged prostate (BPH).
- Core Indications (Remove ASAP)
- Acute urinary retention / bladder outlet obstruction.
- Strict I/O monitoring in critically ill patients.
- Major surgery.
- Healing severe sacral/perineal wounds in incontinent patients.
- Contraindication: Suspected urethral injury (blood at meatus).
- Complications
- CAUTI (Most Common)
- Patho: Bacteria form a protective biofilm.
- Dx Pearl: Only diagnose/treat if patient is symptomatic (fever, altered mental status, CVA tenderness).
- Rule: Do NOT treat asymptomatic bacteriuria. Pyuria is expected with a catheter.
- Non-Infectious: Urethral trauma/strictures, bladder spasms, obstruction. Long-term use risk for squamous cell carcinoma.
- Essential Management
- Prevention: Aseptic insertion, maintain a closed drainage system, keep bag below bladder.
- CAUTI Treatment:
- Step 1: Remove or replace the catheter. This is critical.
- Step 2: Obtain culture from the new catheter, not the old one.
- Step 3: Start antibiotics.