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The correct way to change a SP catheter?

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    #16
    The gap in time, wow, that's just so out of sync with what we do and were told to do - I get everything ready and the new cath is in within 10-15 seconds max. I agree with the common sense thought of that-just-aint-right ... and would get her to put the new one in immediately. What the heckola could she do for 5 minutes after removing it anyway?!? Geez. Anyway, good luck!
    Wife of Chad (C4/5 since 1988), mom of a great teenager

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      #17
      If you remember the glove isn't sterile after pulling it out and have the sterile glove ready to insert the new one, you are fine.

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        #18
        Honestly when I have changed gloves during the process I can't remember which gloves I used first. But I can see where the ones in the kit would be sterile and the boxed gloves would not. Thanks so much for pointing this out.

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          #19
          First off make sure the nurse washes her hands real good when she first comes in your home. Your germs are different than germs brought in from outside. Then my nurse puts on non sterile gloves after washing her hands & wears them until she gets sterile. I watch my nurse extremely careful from the point she starts to get sterile (opens the catheter kit) til it's over. If she touches anything non sterile with her sterile gloves we get another kit and start over. I like to use 1 of the 3 betadine swabs to clean around the stoma while the old catheter is still in & the other 2 before the new catheter is put in. Rubbing the swab around the stoma without a catheter in makes me worry about germs being pushed inside. Even if it was washed real good with soap & water.
          But to me the # 1 most important thing is I ask her not to touch the bottom 5-6"'s of the catheter tip that goes inside the bladder. No matter what. Even if she has on sterile gloves. Just don't touch it no matter what.
          sigpic

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            #20
            Our kits only have two swabs in them, what is the third one for that a couple of you have mentioned?

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              #21
              MSWIFE, the cath change kits are for all types of cath users. There may be other uses, but I know from experience that third swab is necessary when doing a change for women using indwelling urethral catheters -- first swab cleans the left cleft between the labia, the second cleans the right, and swab three cleans right down the middle.
              It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience.

              ~Julius Caesar

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                #22
                Thanks thehipcrip, that makes sense.

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                  #23
                  You are absolutely correct. That is really the main reason for the 3 swabs....

                  CKF
                  The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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                    #24
                    When you get tired of those SP UTI's and compications then get you a urostomy. Seems drastic but I have not been in the hospital for a UTI since having it done. I could write a book on SP complications through the years

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                      #25
                      This is exactly the way my family and my wife were taught 25 years ago with one additional step. Without touching anything after removing the old catheter and discarding it she washes her hands, carefully opens the kit being extra sure to not touch anything non sterile. Put on the sterile gloves, she swabs in a circular fashion starting at the edge of the site and spiraling outward for about 2 inches. Our kits have 3 swabs and they are all used in this manner. she inflates and deflates the balloon to make sure it functions properly, pushes the air out of the tip of the saline syringe, then the tube is lubricated and inserted. After getting a return the balloon is inflated inside my bladder.

                      I have had faulty balloons in the past so the extra step of inflating and de4flating it before lubrication and insertion prevents this problem. Also if it is changed very quickly sometimes you will get little or no return so she wiggles it in and gently pulls out on it to make sure it is free moving and inserted properly and if still no return we will flush some saline in to make sure we get return.



                      Originally posted by Spadfan View Post
                      [FONT="]
                      [/FONT] [FONT="]This is similar to the procedure that we have followed for years (30+). The only differences being that we don’t do a betadine cleaning before removing the tube. On the day the tube is changed my wife shaves the area and then I take my shower and wash around the tube thoroughly with soap and water. I then get back into bed to change the tube.[/FONT]

                      Betty gets everything ready to go as described above, but removes the old tube before gloving. Touching the tube after gloving breaks the sterile technique because the old tube is not sterile. After putting on the sterile gloves, she swabs in a circular fashion starting at the edge of the site and spiraling outward for about 2 inches. Our kits have 3 swabs and they are all used in this manner. Next the tube is lubricated and inserted. After getting a return the balloon is inflated.
                      ^^(A)^^

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                        #26
                        Sometimes the lubricating gel will clog the eyelets of a catheter. If you wait for a few minutes you might not need to flush the catheter. Lubricating gels are water soluble and urine will flow once the gel has been exposed to enough liquid.

                        All the best,
                        GJ

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