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URINARY CATHETER MANAGEMENT
EMS providers should empty urinary catheter collection containers prior to transport to avoid back-up that may cause infection to the patient.
- Always note the amount and color of the contents.
- When transporting patients with indwelling urinary catheters, never raise the collection bag above the level of the patient's waist as backflow of urine from the foley tubing/bag can lead to a urinary tract infection (UTI).
- Caution should also be taken when handling the collection bag as a puncture will not only result in a mess, but it also breaks the closed-system and can introduce new bacteria into the tubing and up the catheter, causing infection to the patient.
EMS providers should take special care to refrain from pulling or dislodging a urinary catheter, which could possibly result in injury and immense pain to the patient. (There is an inflated balloon holding the catheter in the bladder. Forced extraction of this inflated balloon will traumatize the small caliber urethra, causing exquisite pain. You could only imagine!
Be sure to evaluate your patient well as urinary catheters increase the risk for a UTI substantially and can be quite common, requiring further evaluation and intervention.
In the Field
If you arrive on site and your patient has an indwelling urinary catheter, assume he or she is very sick:
- sick enough to require accurate I&O (input/output measurements) or
- sick from the complications of chronic indwelling catheters, such as UTIs, pyelonephritis, sepsis, or sepsis-related shock.
►Call to Action: TRANSPORT
Evaluate your patient for any elevation of the heart rate (>100), fever (>100.4) and any acute mental status changes once you establish what their normal baseline is as this may indicate that the patient has a UTI or worse--sepsis or uremia. Should you encounter abnormal findings, the patient needs to be evaluated at an emergency department.