Catheterisation in Adults - the Royal Cornwall Hospitals Trust ...

Catheters should be re moved wherever clinically possible, following individual assessment,which takes into accou nt the patie nt’s condition and in co llaboration with the healthcareteam. Removal of the catheter sh ould be considered at each review, unless the patient'scondition requires continued catheterisation for clinical benefit and/or quality of life.Following removal, the patient’s condition should be monitored. A bladder scan ( portable)should be performed in the first few hours to measure for post-void residual urine, becauseurine retention is possible followin g removal of catheter and action should be t aken asnecessary (Appendix 6). Post-ope ratively, the catheter should be removed as soon asclinically possible. Attempts should be made to avoid removal of an in dwelling catheter onthe day of discharge or transfer from hospital.4.28 Adverse EventsConsideration should be given to user sensitisation to lat ex products, especially in thosepatients with spina bifida as they are a t high risk due to repeated exposurewww.asbah.org/libraryAutonomic dysreflexia is a serious life threatening condition that affects people with spinalcord injury at or above t he level of the 6th thoracic vertebrae. Bladder problems are one ofthe most common causes of this condition (Appendix 7).Lidocaine based lubricating gels should not be used during a catheterisation procedure inthe following circumstances:a) If the patient states they have an allergy/hypersensitivity to any of the activeingredients within the product.b) If the patient has noticeable abrasions and lesions on the penis or urethral orifice.Local anaesthetics should not be applied to a traumatised urethra as the drug maybe so rapidly absorbed that a systemic, rather than a local, reaction is produced(BNF 2012). These could include confusion, respiratory depression and convulsions;hypertension; and bradycardia (may lead to cardiac arrest).c) Nursing assessment prior to administration should include identification of patients atincreased risk of systemic effects and checking for possible drug interactions.d) All medical devices and medicinal products containing chlorhexidine have beenidentified as being a risk for anaphylactic reaction. HCP should ensure that anyknown allergies are recorded in the patient notes and report any adverse events tothe MHRA (MDA/2012/075)http://www.mhra.gov.uk/Publications/Safetywarnings/MedicalDeviceAlerts4.29 Bladder & Bowel Specialist ServiceThis is a sp ecialist service, which of fers professional advice, guidance a nd information onthe promotion and management of continen ce; and fa cilitates best practice in continencecare for faecal and urinary incontinence, includ ing enuresis, and related bladder and bowelproblems for children and adults.For any further information or feedcontact via:back on the contents of this guideline, please makeBladder & Bowel Specialist ServiceSt Austell Community HospitalPorthpean RoadSt AustellPL26 6ADTel: 01726 29104212 of 16