Catheterisation Flashcards
Indications for urinary catheterisation
acute/chronic urinary retention
output monitoring
incontinence
to aid surgery
contraindications for urinary catheterisation
pelvic injury (e.g. fracture) acute prostatitis
when is suprapubic catheterisation indicated
mandatory in pelvic trauma and suspected urethral injury
complications of urethral catheterisation
retrograde infection
paraphimosis
creation of false passages
urethral strictures
urethral perforation
bleeding
how do you properly take a urine sample from a catheter
aseptic aspiration from a port in the catheter tubing or aspiration of the tubing
never from the bag
what is the difference between a closed and open suction drain
open drains are passive drains that lead into a stoma or dressing to provide a conduit for flow
closed drains are tube systems that drain directly into a container, these may be passive or active
what are the indications for wound drains
To remove existing abnormal collections of fluid, blood, pus or air.
To prevent build up of bodily fluids (e.g. bile), abnormal fluids or air.
To warn of potentially serious complications.
what is the indication for removal of a wound drain
Time-course depends on the purpose of the drain, e.g. by 48h if covering
peri-operative bleeding, by day 7 if covering intestinal anastomoses.
what are some common complications of wound drains
Damage to structures during insertion, avoided by image-guided insertion.
Damage to structures due to pressure effects of the drain.
Infection, avoided by timely removal of the drain.
Failure of the drain, which can give a ‘false sense of security’, so proper observation of the patient’s clinical state is still necessary
what are indications for a central venous catheter
Critically ill patients requiring continuous CVP monitoring (of fluid)
Infusion of irritant substances
Precise infusion of substances with a very narrow therapeutic window
Long-term access for parenteral nutrition chemotherapy or antibiotics.
Haemodialysis.
No other venous access available.
what are the types of central venous lines
hickman (tunneled beneath skin)
PICC line
portacath
what are complications of central venous lines
Haemorrhage/ arterial puncture.
Pneumothorax.
Thoracic duct damage.
Air embolism.
Thrombosis.
Catheter-related sepsis.
what is a swan-ganz catheter
balloon catheter used to measure pulmonary artery pressures or the wedge pressure of smaller pulmonary vessels
what does a high pulmonary wedge pressure indicate
heart failure
what are indications for a swan-ganz catheter
Assessment of haemodynamic response to therapies (ITU)
Monitoring of complicated Ml/ post cardiac surgery
Diagnosis of high vs. low pressure pulmonary oedema
Diagnosis of idiopathic pulmonary hypertension/ PE
