Blocked Urinary Catheter 🚫💧
Clinical guide for managing blocked urinary catheters. Irrigation techniques, replacement, urosepsis prevention, and catheter care for on-call doctors.
🧠 Definition
- A blocked catheter refers to impaired drainage of urine through an indwelling urinary catheter (IDC).
- Can lead to urinary retention, bladder distension, pain, or infection.
📞 What to Ask / Orders to Make
- When was the catheter inserted or last changed?
- Any bypassing or leakage around the catheter?
- Volume of urine drained recently?
- Any recent flushes or traction applied?
- Is the patient in discomfort or showing signs of sepsis?
- Request nurse to check tubing and drainage bag positioning.
- Order a bladder scan if no output or concern for retention.
🧾 History
- Onset and duration of reduced output.
- Pain, discomfort, fever, rigors?
- History of catheter blockages or encrustation?
- Underlying urological conditions (e.g. prostate issues, stones)?
- Any trauma or traction on catheter?
🩺 Examination
- Vitals: temp, HR, BP—assess for urosepsis.
- Abdominal exam: palpable bladder or tenderness?
- Check for leakage around catheter.
- Inspect catheter tubing for kinks or dislodgement.
🔍 Investigations
- Bladder scan to assess retention.
- Urinalysis and urine culture if suspicious of infection.
- Bloods: FBC, U&E, CRP if febrile or unwell.
- Consider imaging (e.g. renal ultrasound) if recurrent blockages or suspect obstruction.
💊 Management
- Ensure catheter tubing is not kinked or pulled.
- Try flushing catheter gently with 10–20ml sterile saline.
- If unsuccessful, change catheter using aseptic technique.
- Document volume drained and character of urine.
- Send catheter tip and urine for MCS if changed.
- If febrile or unwell: treat as possible urosepsis, start empiric antibiotics, escalate.
🚩 Red Flags
- Palpable, painful bladder and no output → urgent action required.
- Fever or signs of sepsis in catheterised patient.
- Multiple failed attempts to relieve blockage.
- Recent urological surgery—consult seniors or urology early.