Blocked Urinary Catheter 🚫💧

Clinical guide for managing blocked urinary catheters. Irrigation techniques, replacement, urosepsis prevention, and catheter care for on-call doctors.

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🧠 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.
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Blocked Urinary Catheter 🚫💧 - BetterCall.ie