Standards Procedure (Skill)
Clinical Indications: Level: EMT-P only
Ø Monitoring a patient’s fluid status and/or response to therapy during transport
Ø Collection of urine for laboratory analysis
Ø Patient’s with medical (BUT NOT TRAUMA) complaints over the age of 16
Procedure:
a. Explain the procedure to the patient. Maximize patient privacy. Have a second crew member or other chaperone if performing the procedure on a member of the opposite sex.
b. If there is any concern of traumatic injury to the genitourinary (GU) region, do not perform this procedure.
c. Using a sterile technique, open the catheter kit. Test the balloon at the catheter tip. Connect the catheter to the urine collection system.
d. Don the sterile gloves from the kit. Use one hand to come in contact with the patient and the other to use items from the kit. Recall that once your hand comes in contact with the patient, it is no longer sterile and cannot be used to obtain items from the kit.
e. Using the Betadine swabs from the kit, thoroughly cleanse the area around the urethra. For males this will require retracting the foreskin of the penis for uncircumcised males and cleansing the glans for all males. For females this will require retraction of the labia majora and cleansing the area around the urethra.
f. Once the patient has been cleansed with Betadine, place sterile sheets.
g. Lubricate the distal tip of the sterile catheter.
h. While retracting the skin (foreskin for males and labia majora for females), visualize the urethral opening. Gently guide the catheter through external opening of the urethra. Advance the catheter slowly until there is a return of urine. Do not force the catheter through any resistance that is met. If resistance is encountered, withdraw the catheter slightly and gently re-direct the catheter.
i. Once the urine is returned, gently inflate the balloon and secure the urine collection device.
j. Record the procedure, time and patient response on the ACR.
Certification Requirements:
Successfully complete an annual skill evaluation including the indications, contraindications, technique, and possible complications of the procedure.