Let's examine male
indwelling catheter removal.
So before we get started,
make sure you raise the patient's
bed to an appropriate level.
We want to perform our hand hygiene
and we want to don our gloves.
Now make sure you empty that urine from
the drainage bag and record this volume.
This is important in regards to
the patient's intake and output.
Now to prep the patient,
place the absorbent pad
beneath the patient's buttocks.
Now don't forget, let's take a look
at all the stuff we're going to need.
That absorbent pad of course,
a 10 mL Luer lock syringe,
and also supplies
for perineal care.
To get started with this skill,
make sure to perform your hand
hygiene and provide privacy.
Now this next step is crucial.
Make sure explain the
procedure to the patient.
As you can imagine with someone
with an indwelling catheter,
there may be some fear, some anxious
feelings about getting this removed.
So take time here and
explain this thoroughly.
We also want to get our patient
in the optimal position.
So as you see here, on this image,
there's a male client in a supine position.
And just a fun trick to remember
the patients laying on their back,
hands up like
they're holding soup,
just something that I used
to remember this position.
We also want to make sure to remove
the catheter securing device.
This thing can be on
the patient's leg,
it can be really
uncomfortable to remove.
So be gentle, be kind here and
make sure you remove this device.
Now we can take that 10 mL syringe
to the catheters balloon Luer lock
and gently remove the
water from the balloon.
Now this is really important,
if you look at this image,
notice that we have the plunger
and removing it backwards.
This is going to help
remove that water.
Make sure you take time to get all the
water out of the urinary catheter balloon.
One thing to help with comfort,
ask the patient to
take a deep breath.
And while the
patient's doing that
hold the patient's penis
away from the body.
And as they release the breath,
gently remove that catheter.
Now if you feel resistance,
stop and take a pause.
We don't want to cause
trauma to the patient,
have the patient
relax and try again.
And after the procedure make sure
you provide thorough perineal care.
Once treatment is complete,
let's discuss how we remove an indwelling
catheter from our male patient.
So of course we want to perform our
hand hygiene and provide privacy.
This is really important to explain
the procedure to the patient.
And of course,
like all procedures,
but I will tell you specifically
for the male patient,
there could be some anxiousness and some
fear that this procedure could be painful.
Now assure them this should be
quick and timely on the removal,
it can be slightly uncomfortable,
so prepare your patient.
It should however,
not be really painful for your person.
So again, comfort them,
let them know what's ahead.
So we want to also make sure we
assist the patient in a position
that's easily accessible
for the catheter.
So most of the time
for our male patients,
they're going to be in a supine position
who where they're laying on their back.
Now your patient should have
a catheter securement device.
This is really important
to prevent excess tugging.
But before you remove it,
go ahead and take this off your patient.
Typically you're going to find
this on your patient's thigh,
you can be really kind and
use maybe an adhesive remover
to loosen up that adhesive off
the skin or an alcohol pad.
But be gentle because this
can pull on the patient's skin
and a little bit on
their hair on their leg.
So once we've removed the
catheter securement device,
we can go ahead and get our Luer
lock syringe and deflate the balloon.
So at this point,
I've got my patient here, Larry,
and I'm going to go ahead
and pull back the covers
because I'm going to need
to support him upon removal.
"Okay, Larry, I'm just pulling back the
covers here so I can get to your catheter."
"So you can go ahead just relax.
I'm just taking out...
the water from the balloon."
So I'm going to take
my 10 mL syringe
and this is going to
go to the balloon port.
So luckily, it's one of the only
ports that's going to come off
besides of course,
your urine sample report,
but this is the one
I'm really going for.
So I'm going to take my
syringe and attach this here.
Now there may be some built up pressure
with the balloon which is good,
you can kind of already
see this filling.
We're going to go ahead and assist
and pull back on that plunger
and we should get at least 10 mLs of
syringe of fluid to deflate that balloon.
There may be more though.
So now that I pulled
back, I'm going to detach
and I'm going to go ahead and
squirt this out into my trash can.
So it's really important in
especially in our male patients
because their urethra
is longer that we ensure
there's no sterile
water in the balloon.
We want to make sure
that's completely deflated
before we pull it
through the urethra.
So you see how I pull back my
plunger, there's lots of air in here.
It's a good sign, that means
I've gotten all of my water out.
So I mean, keep that tension
and disconnect the syringe.
Now I can get rid of this.
Now this is the important step.
Now I'm going to talk to Larry and
instruct him to take a deep breath.
And then once he
relaxes and exhales,
that's when I'm going to support
him and remove the catheter.
So let me let you know what's going on.
I want you to take
a deep breath in.
Once you do that,
and you exhale,
I'm going to hold you and I'm also going
to remove the catheter quickly and gently."
"Okay, are you ready?"
So let me go ahead and support my patient
to make sure their urethra is straight.
I want you to take a deep breath.
on exhalation I'm removing.
Okay, go ahead and exhale."
Okay, so now Larry's exhaling and I'm going
to go ahead and punch this in my glove.
That way I can hold
on to the catheter.
Now if I felt a lot of
resistance, I would need to stop.
So just keep that in mind so you don't
cause excess trauma to your patient.
I'd like to hold
this into my glove.
There's going to be mucus, maybe excess
urine in here as well in the catheter.
So be conscious of this and
then dispose of it properly.
Now after the
procedure is complete,
make sure you provide thorough
perineal care for your patient as well
and then lower the
bed before you go.