Overview

Pediatric Urinary Catheterization is a procedure used to insert a catheter into the bladder for urine drainage, diagnostic testing, or therapeutic purposes. This procedure requires specific techniques adapted for pediatric anatomy.

Urinary catheterization is essential for relieving urinary retention, obtaining sterile urine samples, monitoring urine output, and managing various urological conditions in pediatric patients. Proper technique is crucial to avoid complications.

Indications

Urinary Retention

Inability to void with bladder distention

Sterile Urine Sample

Urine culture and sensitivity testing

Urine Output Monitoring

Critical illness, surgery, trauma

Bladder Irrigation

Treatment of bladder conditions

Surgery Preparation

Preoperative bladder drainage

Contraindications

Absolute Contraindications

Urethral trauma
Urethral stricture
Patient or family refusal

Relative Contraindications

Recent urethral surgery
Active urethral infection
Limited experience with procedure

📋 Equipment Checklist

Check off items as you gather them:

Pre-procedure Preparation

Preparation includes explaining the procedure to patient and family, selecting appropriate catheter size, gathering necessary equipment, ensuring proper patient positioning, and preparing for potential complications. All team members should understand their roles.

Step-by-Step Procedure

Step 1: Patient Preparation

Explain procedure to patient and family using age-appropriate language. Position patient appropriately. Ensure privacy and comfort.

⚠️ Common Mistakes to Avoid:

  • Inadequate explanation
  • Poor positioning
  • Insufficient privacy

💡 Pro Tip:

Use age-appropriate language and involve parents in the process.

Step 2: Catheter Selection

Select appropriate catheter size based on patient age and gender. Prepare catheter with lubricant. Check balloon integrity.

⚠️ Common Mistakes to Avoid:

  • Wrong catheter size
  • Inadequate lubrication
  • Damaged catheter

💡 Pro Tip:

Use age-based formulas for catheter size: (age/2) + 6 for children.

Step 3: Genital Cleaning

Clean genital area with antiseptic solution. Use sterile technique. Maintain sterility throughout procedure.

⚠️ Common Mistakes to Avoid:

  • Insufficient cleaning
  • Poor sterile technique
  • Contamination

💡 Pro Tip:

Use sterile technique throughout the procedure.

Step 4: Catheter Insertion

Insert catheter gently into urethra. Advance until urine flows. Inflate balloon if using Foley catheter.

⚠️ Common Mistakes to Avoid:

  • Forceful insertion
  • Inadequate advancement
  • Wrong balloon inflation

💡 Pro Tip:

Insert gently and advance until urine flows freely.

Step 5: Placement Confirmation

Confirm proper placement with urine flow, balloon inflation, and patient comfort. Secure catheter appropriately.

⚠️ Common Mistakes to Avoid:

  • Poor confirmation
  • Inadequate securing
  • Poor patient comfort

💡 Pro Tip:

Always confirm proper placement before securing.

Step 6: Post-Insertion Care

Connect to collection bag. Secure catheter. Document procedure details. Monitor for complications.

⚠️ Common Mistakes to Avoid:

  • Poor connection
  • Inadequate securing
  • Poor documentation

💡 Pro Tip:

Secure the catheter properly to prevent dislodgement.

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Post-procedure Care

Post-insertion care involves confirming proper placement, securing the catheter, monitoring for complications, and documenting the procedure. Regular assessment of catheter function is essential.

Complications & Management

Complication Incidence Signs Management Prevention
Urinary tract infection 10-30% Fever, dysuria, cloudy urine Antibiotics, catheter removal if needed Strict aseptic technique, proper care
Urethral trauma 1-5% Pain, bleeding, difficulty voiding Remove catheter, urological consultation Gentle technique, proper lubrication
Catheter dislodgement 5-15% Leakage, poor drainage Remove catheter, reinsert if needed Proper securing, monitoring
Bladder spasm 10-20% Pain, urgency, leakage Anticholinergics, catheter adjustment Proper catheter size, technique

Clinical Pearls

💡

Use age-appropriate language and involve parents in the process.

🎯

Use age-based formulas for catheter size: (age/2) + 6 for children.

Use sterile technique throughout the procedure.

🔍

Insert gently and advance until urine flows freely.

📊

Always confirm proper placement before securing.

🎨

Secure the catheter properly to prevent dislodgement.

⚠️

Maintain sterility throughout the procedure.