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Catheter fixation devices and catheter associated urinary tract infections

16 July 2013

Q19. What is catheter fixation and should I use one?

 

A19. Secure catheter fixation is an important part of catheter management, but is often neglected or equipment is used that is not designed for this purpose: for example, sticking plaster. If a catheter becomes dislodged, there can be severe trauma to your urethra, causing pain and the potential risk of infection. If the catheter bag becomes too heavy with urine, and it is not supported properly, the bag can pull on the catheter, this along with catheter movement at the site of insertion, can cause discomfort and irritation to you. So the answer is yes catheter fixation should be used.  Specifically designed Velcro straps are often used to position a catheter but these can act as a tourniquet so be cautious if using this type and check it is not on to tight. Be sure to wash the straps with soap and water regularly.  Ideally the catheter fixation should be:

  • Designed to secure the Foley catheter

  • Allow security without tension on the urethral tissue and your bladder neck

  • Suit your lifestyle

  • Convenient and uncomplicated to apply

These devices are available on prescription, ‘Griplock’ and ‘Statlock’ are two leading brands. These can be order through our online Pharmacy with a prescription.

 

Q20. How will I know if I am getting a urinary tract infection with a catheter in?

 

A20.  A urinary tract infection (also called ‘UTI’) is an infection in the urinary system; this includes the bladder (which stores the urine) and the kidneys (which filter the blood to make urine). Germs (for example, bacteria or yeasts) don’t usually live in these areas however if germs are present then an infection can occur. 

The germs can travel along your urinary catheter, and cause an infec¬tion in your bladder or your kidney and this is known as a catheter-associated urinary tract infection (or “CAUTI”).

The following are symptoms of a urinary tract infection:

  • Fever 

  • Chills 

  • Leakage (wetness around the catheter) 

  • Increased spasms of legs, abdomen, or bladder 

  • Burning of the urethra, penis, or public area 

  • Nausea 

  • Headache 

  • Mild low back pain or other aches 

  • Feeling  generally unwell or tired 

The following are signs of a urinary tract infection: 

  • Sediment (gritty particles) or mucus in the urine

  • Cloudy urine 

  • Smelly urine 

  • Blood in urine (pink or red urine) 

NB: Not all these signs and symptoms will be present and the look and smell of your urine may change because of alterations in your fluid or diet intake. Changes in the urine without symptoms are not reason enough to seek treatment for a UTI. 

 

Q21. Do all catheter-associated urinary tract infections (CAUTIs) need to be treated?

 

A21. No. Even with the most careful hygiene, individuals with an indwelling catheter are very likely to develop bacteria in the urine (bacteriuria) at some point. In fact between 90% and 100% of patients who undergo long-term catheterization eventually develop bacteriuria. The bacteria may gain entry into the bladder during insertion of the catheter, during manipulation of the catheter or the drainage system, around the catheter, and after removal.  Intermittent catheterisation, where a catheter is inserted to drain the urine once or several times a day and then removed, carries less risk of infection but this is not always possible. (See entry on intermittent catheterisation for more information)

As a general rule bacteriuria without accompanying symptoms of a urinary tract infection (Asymptomatic bacteriuria) should not be treated in long-term catheter users.

However if the CAUTI is symptomatic in other words you have symptoms which are causing you to feel unwell or become confused (more common in the elderly) then a urine sample is usually taken from the catheter (there is a special ‘sample port’ on the catheter tubing to get a fresh specimen of urine). A dipstick test of this urine which can be carried out by a healthcare professional (your District Nurse/Practice Nurse) will give immediate results as to whether you have a positive infection. You may then be started on a course of antibiotics. Sometimes a specimen will be sent to the laboratory to confirm which antibiotic will be effective on the CAUTI but often a course is started even if waiting for the results. 

Amongst others, people with Diabetes, females, the elderly and people with spinal injuries are more at risk of becoming poorly with a catheter in place therefore close monitoring of the signs and symptoms of a urinary tract infection when a catheter is in place is very important. 

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