Clinical Skills Flashcards
Outline how to do an instrument tie after suturing
- Create a short and long end of thread
- 2 loops of long end around needle holder, away from you
- Hold short end with needle holder, hold remaining long end of thread with finger.
- Pull in opposite directions
Repeat;
- 1 loop towards you
- 1 loop away from you
Outline how to do a Female catheterisation
(Wash hands where possible, always use aseptic technique)
Ask patient if any allergies, prior negative experiences or phobias
(Similar for Male urethra, generally easier if penis held vertically as possible)
Prepare tools (Catheter, catheter pack, x2 sterile glove pairs, alcohol wipe, saline ampule, anaesthetic) and uncover patient
Open catheter pack, clean saline ampule with wipe for 15s, allow to dry. Pour saline into plastic pot, and leave cotton balls inside.
Put on sterile gloves and put sterile field over pt (may need to make hole in paper)
Use ‘clean’ and ‘dirty’ hand to clean vagina. 1 wipe downwards. Repeat for L+R Inner + Outer labia.
Dribble anaesthetic over urethra, then inject all into urethra. Remove sterile gloves and wash hands and prepare, waiting 5mins before inserting catheter.
Put on sterile gloves after opening catheter and included 10ml water syringe onto sterile field on trolley. Put reliever below patient to catch urine.
Insert catheter into urethra until urine flashback seen, then advance 5cm. Inject all 10ml in syringe to inflate catheter balloon. Watch patient’s face as this is done, to look for pain. (If pain, consider that catheter balloon in wrong place)
Twist syringe before removing. Connect port to catheter bag quickly to miniseries urine leakage. Give gentle tug of catheter to ensure balloon sitting at bladder neck.
Aftercare: TINKLE;
- Trauma (Blood, pain etc)
- Infection (Smell, appearance)
- Non-drainage (Pain, little or no urine collection)
- Kink (minimise catheter movement)
- Leakage (If liquid comes out outside of catheter)
- Expulsion (If pulled out)
