 and welcome back to another vlog and catheter care and why we need catheters and all that jazz. I had a lovely request for this video and actually I thought it was a really good idea because I don't do as many skills-based kind of videos and I think actually I should be doing more of those just to help you out maybe a little bit. So yes today is all about catheters. Firstly a catheter is a tube that goes into your bladder and this helps to drain any urine and there will be a bag attached on the end to catch the urine it's not just going to go everywhere on the floor honestly it's in a bag so it's a tube and a bag done. Now there are a couple of types of different catheters I'm going to use images because I'm at home I have not got catheters lying around my house I might have a speculum but not a catheter. So this bag here is your catheter so this goes as it says on the tin it goes straight into the urethra into the bladder and drains the urine directly from there. And this is sometimes called like a leg bag or a night bag or people have all these weird and wonderful names for it but normally it sort of hangs out and attaches to the leg. If someone is in bed it should really be attached to a little stand or something so that it can drain properly and not get blocked. And this type of catheter can be inserted by nurses and doctors. I've inserted some female catheters I haven't done a male catheter yet because you need the extra training which I'm assuming they're doing at uni now because I think the guidelines and everything have changed but when I trained we weren't allowed to do male catheters just because of the anatomy and the danger of the prostate and all of that jazz so we just had the female catheters to do just because the urethra is quite small and it's quite an easy-ish one to sort of navigate and put in but it was really really simple I found it really really simple I'm saying it's really simple but actually it's not really simple but I found it for some reason just really simple to do I never had a problem I think I was just lucky with the anatomy and physiology of the females I had it was there I could visualize it it was straight in and when you insert a catheter it is aseptic technique because you don't want to insert any bacteria or anything into that area because they're going to end up with urine infections they could end up with sepsis and all sorts so really really important that it's aseptic you keep that sterile field as clean as possible and you'll be okay now the tricky part that was the easy part you know you have the tube you have the bag but then there's the tap another tap is very different on every bag and I don't 100 know what the not what the difference is but why they choose certain taps over other taps I don't know but you have the flip tap which is just literally you flip it on flip it off to get the urine out there's other taps that you have to turn there's another tap that you push across so it's like a little bit I'll put a picture here but it's like a little bit that you push across so that when you push it across the urine comes out and one of the biggest problems with these taps is sometimes people forget to close them I've done it absolutely I've forgotten to close it you've got urine all over the floor and you're thinking nightmare what a plonker and next you also have the night bags and day bags so the day bags are a certain size and then you have the night bags that are a bit bigger some people attach a bag onto a bag as well I've seen that done before but I'm not 100% sure about the guidelines around that but I'm going to put some information below if you really want to look it up go for it knock yourself out guys and also there are two types of these sort of catheters if I make sense I don't know but one is called the intermittent catheter so this is a catheter that a patient can actually change the cells quite regularly throughout the day so they do it themselves they're trained to do that and this is just inserted a few times a day that allows people to just drain it into the toilet still that makes sense however in my head I think this could have the potential to cause maybe some urinary tract infections because you're constantly changing it there is that little bit more risk maybe I don't know but it is a really good tool for those people that really need it and then there is the indwelling urinary catheter which is pretty much the first kind of one that I spoke about so it's inserted into the refra and it's left that is it inserted in there's a little balloon that you pump up and it stays in until it's due to be changed or if it gets blocked or something happens but that catheter will stay in and it's just the bag bit that gets changed every so often so leg bags on indwelling catheters should be changed every seven days and you should normally it's really good practice to date and sign the back of it just in pen just so that you know when it's last been changed and what time so that you know that in seven days time you change that leg bag again and this isn't the whole catheter this is literally just the the tubing and the leg bag on the end most indwelling catheters need to be changed every three months sometimes before if there's any issues the next type of a catheter is the super pubic catheter and I'm going to put an image here again so this catheter is actually a surgical procedure and they have to cut a little hole into your lower abdomen and then they thread the tube through there into the bladder and then you have the bag on the end to release the urine and the super pubic catheter can be done under general anaesthetic an epidural or even local anaesthetic and the super pubic catheter is used if the urethra is completely blocked so they can't use that end or if they're unable to use an intermittent catheter also these have a bag as well so these can either have a bag and it sits on the side of your body or the patient's body or it can be connected with a little valve so then you just go into the toilet empty it and then go back to your seat or whatever you're doing and this catheter is usually changed every four to twelve weeks and another type that you may not have heard of is called a yourostomy bag so this is a bit like a stoma bag if you've ever seen a stoma bag it literally sits on the abdomen like a bag I'm going to put a picture here again and this is done after you've had surgery to remove your bladder for whatever reason and they replace it with this bag so you'll have this it'll look like a sort of hole going in through the abdomen and the bag is attached to this directly to the hole there's no like big long tube or anything it's literally just attached to the hole and that's where the urine comes out of if you want to know a little bit more about your rostomy bags or stoma bags please go and follow my amazing amazing friend Rachel I'm going to put her blog below because she's got both a stoma and your rostomy and she writes amazing blogs to make more awareness around it she's done loads of photo shoots and stuff with them and she's amazing like the strength this girl has is incredible she's the one of the most inspiring people that I know and I know a few inspiring people but she's up there like she is up there because she is amazing so please go and check out her blog she's really really informative and if you're on twitter or instagram she is also on those places links below guys go and give her a follow and last but not least is the male catheter sheaf or the male sheaf catheter sometimes it's called a sheaf it might be called something completely different where you are I'm gonna put an image up so I'm going to warn you now there is a bit of a graphic image coming up of the male anatomy don't be alarmed but if you don't want to see it maybe skip I don't know however many minutes I'll put it here how long you should skip after the video is done but here it is and this is a little bit like a condom so it'll be the ones that I've seen in the hospitals is like a little plastic rubbery bit that sort of goes over the penis and then there's a tube with a bag on it so it literally like a temporary thing so you put it on they sleep with it they use it in the day whatever and then it gets disposed of and they have a new one the next day they do come in different sizes so make sure you've got the right size for your patient these catheters are used if anyone has real difficulty in urinating it can also be used before or after surgery as well to help perform certain tests for example but more specific reasons the catheter might be used could be things such as if you have some sort of bladder obstruction or urethra obstruction if you have any form of bladder damage or maybe nerve damage that affects your ability to go to the toilet some um pregnant people have uh it during childbirth if they have an epidural because they will see everything's numb from the waist down so they haven't got control over their bladder so that might need it this is also common in surgery as well so any type of surgery if you've had an epidural where you can't control it they might insert a catheter some people also have it to insert things like chemotherapy directly into the bladder so if your patient has cancer of the bladder they might have this type of bag as well just to deliver any form of medication directly to the bladder and as a massive massive massive very very last resort for somebody that has complete urinary incontinence and it will be as a very last resort just because of the risk of infections and we don't usually just insert a catheter for fun if someone's incontinence so you have to do everything you can first and then if it's that severe and they might think about putting a urinary catheter in catheter care so how to look after a catheter so as I said the bags will be changed sort of regularly just to keep it clean and sterile as possible to prevent those uti's from coming also you would empty it as least as possible really because you don't want to keep opening that valve because you're going to be allowing bacteria to travel up into the bag and through the urethra and all that jazz so you're trying to minimize that risk of infection so you shouldn't really be opening and closing that valve all day every day you should just be doing it like when the bag's getting full then empty it all at once and then allow it to fill again so if your patient is able bodied and they can wash themselves properly then you should be training your patient to clean around the tubing that goes into the urethra because they have to keep that clean just to prevent again any infections from going up there so keeping it clean sometimes you can get like a little bit of like discharge around the tubing and it can get a little bit mucky so it's really important that that bit is clean like daily and if they can't do it then please make sure that you do it if you're washing and helping your patient to wash and dress and they can't do that then please help your patient to do that and make sure that that's clean and dried properly dignity with a catheter this is a big one because i've seen this so many times and i just think why why have you done that why um when patients have a catheter and the tubing is very very long and they need to go to the toilet for example because the bowels are okay so they need to go to the toilet or they need to go to the shower room for whatever reason or they're walking down the corridor and they've got a zimmer frame or a walking frame whatever you want to call it and people come along and they take their patient and they put the catheter over the frame i'm just like where is that person's dignity like that everyone in that building can see that this person's got a catheter whatever color they can see whatever their color their urine is it's just not very dignified and it used to infuriate me and i used to be like no why have you done that so please please please if you're walking your patient around just put it in a discreet place i mean some patients don't mind they're just like yeah whatever but if that was me i would not want my urine bag hanging over uh my frame for all to see whilst i'm walking that's not dignified to me so please think about that when you're out there look after your patients maintain their dignity put the bag onto the leg make sure it's covered up it make sure they've got a blanket if they're sitting in their chair so that that is not on show make sure it's sort of hiding under a way like i used to always took the bag away if they were sitting in hospital chairs i would put the bag on a stand around the side if they didn't have straps to the legs or if it was too long for example but there's little things you can do like get a shorter tubing get some leg straps to strap it to their legs so that it's not on show all the time just please think about dignity thank you now your patient may have bladder spasms they might have stomach cramps because obviously you're putting something into the bladder and your automatic reaction your body is going to going to do this because it's trying to expel it back out because it's not normally there but it should settle and if this is like ongoing problems that they're having they can be prescribed some medication to sort of relieve those symptoms and those spasms just to give them a bit of a break catheters can leak as well so if it's leaked the first thing you want to do is maybe just flush it out to make sure it's not blocked and if it's blocked then the whole catheter might have to be changed like the tubing the urethra everything sometimes catheters can be pulled out i've seen this we had a one dementia patient who pulled the catheter out the bag inflated and all and it caused a little bit of trauma and there's a little bit of blood and things it wasn't very nice to be honest but it can happen like people can get it caught on things and as they're walking it can just pull out it is a possibility and that can't be very nice for any patient if you see blood in the catheter bag so it will be red in colour and there's no explanation for it and you're thinking oh god this person has got hematosed blood then you need to contact the doctor and get them to check everything out maybe do maybe take a urine sample from the catheter as well um oh actually urine samples from catheters i will cover that and other problems like i've already spoke about urinary tract infections uti's are common if someone has a catheter so just keeping an eye on that and making sure that there's no urinary problems which leads me perfectly on to getting your urine sample to test for a urine infection so in the catheter at the top where the tube connects there is a little normally nine times out of ten there is a little section i'm going to put a picture here there's a little section that you can put a needle into um it'll be a little plastic piece and it'll have a rubber bit a little rubber bit and you get a syringe and you get your needle doesn't matter really i use a green needle i think i think it was a green needle it's been that long since i've done this guy so get your syringe 10 mil syringe 20 mil syringe enough to fill up your urine part put that needle into it and then you draw back and you get the urine out of it and then you can put it into your urine part and send off you should label it clearly as well on the forms and part that it's from a catheter because that bit at the top in the tube is the most sterile part you know that's going to be fresher than the stuff that's sitting at the bottom of the catheter so if you're opening the tap to get some urine like i did at the start no one had told me how to get a urine sample from a catheter so i was opening the tap getting it and that was it until someone said whoa hang on you shouldn't be doing that and i was like no one's ever told me this i just assumed that's what you do until i discovered the little bit that you get a syringe it's sterile job done but obviously this is just for more than indwelling catheters if someone has a super pubic catheter or if they have the catheter sheath over the top or if they have the urostomy bag then the way that you take your urine sample is going to be different because they might not have that little bit that you can take a sample from you might just have to do it from the tap or the valve but as long as you've got the urine sample then hopefully that should be okay but that's the only way to do it on some bags unfortunately but if you can take it from a more better way like the little adjustment on the indwelling ones then do that so i think that is it it depends very much depends on your patient what's happening to them if they're having surgery if they've got a condition things like that to what types of bags they will have so just find out what your patient is having and why just to get a little bit of background information and then you can adjust what you do to that catheter if that makes sense so you know when to change it you know when to change the bag you don't know how you know how often to do it and all that jazz i think that covered most of catheters and i've already covered how to do the fluid balance charts go and check out that video i'll put a link here somewhere or in the details below and go check that one out if you want to know more specifically about fluid balance but this is just an overview of catheters and i hope that helped you in some way so thanks everyone for watching until next time i'll see you later