catheter

a tubular, flexible instrument, passed through body channels for withdrawal of fluids from (or introduction of fluids into) a body cavity.

A tube passed into the body for evacuating or injecting fluids. It may be made of elastic, elastic web, rubber, glass, metal, or plastic. See: illustration

An intravenous catheter saturated with antibiotics, designed to decrease the likelihood of colonization or infection of indwelling infusion lines.

A catheter inserted into an artery to measure pressure, remove blood, inject medication or radiographic contrast media, or perform an interventional radiological procedure.

A multi-lumened catheter surrounded by a balloon. The balloon may be expanded by injecting air, saline, or contrast medium.

A long, fine catheter specially designed for passage through the lumen of a blood vessel into the arteries or chambers of the heart.

A catheter inserted into a central vein or artery for diagnostic or therapeutic purposes.

A catheter inserted into the superior vena cava to permit intermittent or continuous monitoring of central venous pressure, to administer fluids, medications or nutrition, or to facilitate obtaining blood samples for chemical analysis. See: illustration

Patient care

Health care professionals must use caution to prevent life-threatening complications when inserting and maintaining a central line. The subclavian approach to the placement of a central line is preferred, because femoral placements may be complicated by deep venous thrombosis, and internal jugular sites carry an increased risk of infection. Sterile technique is a requirement during insertion. The skin should be prepared with chlorhexidine-gluconate (2%) or povidone-iodine. Ultrasound guidance improves the likelihood of entering the desired vein without injury to neighboring structures. With or without radiological guidance, the best results are obtained by practitioners who perform the procedure frequently. After the catheter is inserted, it should be firmly sewn to the skin to keep it from migrating in and out of the insertion site. An antibiotic impregnated patch covered by a sterile dressing should be placed at the insertion site. The catheter should be manipulated as infrequently as possible during its use. Dressing changes are carried out using sterile technique. IV tubing and solutions and injection caps also should be changed as required by the agency’s protocol. Health care professionals are responsible for preventing, assessing for, and managing central venous therapy complications (e.g., air embolism; cardiac tamponade; chylothorax, hemothorax, hydrothorax, or pneumothorax; local and systemic infections; and thrombosis). Documentation should include preprocedure and postprocedure physical assessment of the patient, catheter type and size, insertion site location, x-ray confirmation of the placement, catheter insertion distance (in centimeters), and the patient’s tolerance of the procedure. Maintenance care procedures also should be fully documented. The site should be carefully inspected for inflammation, and any drainage should be cultured. When catheter-related infections are suspected, the catheter tip provides valuable information about infection sources in cases of sepsis. The tip should be cut off with sterile scissors and dropped directly into a sterile specimen container.

A specially designed condom that includes a collection tube attached to the distal end. The tubing carries urine to a collecting bag. Its use prevents men with urinary incontinence from soiling clothes or bed linens.

CAUTION!

Continual use of this device may excoriate the skin of the penis.

A catheter providing for inflow and outflow.

A catheter passed into the eustachian tube through the nasal passages to ventilate the middle ear.

A catheter about 5 in (12.7 cm) long, used to pass into a woman's bladder.

A catheter inserted into the ureter to remove impacted kidney stones. A lubricated wire is advanced past the obstructing stone. The glide catheter is mounted on the wire, moved toward the kidney beyond the stone, and used to snare and retrieve the stone.

A catheter that makes it easier to enter that vessel with other devices or instruments. Guide catheters are used to facilitate the placement of lasers, stents, and balloons for angioplasty.

A pulmonary artery catheter with a heparin coating to reduce the risk of thrombus formation.

A catheter coated with a medication to prevent complications of prolonged insertion in the body. Commonly used coatings include antibiotics and antiseptics.

Any catheter that is allowed to remain in place in a vein, artery, or body cavity.

A catheter inserted into the uterus of a woman during labor, when labor is protracted, arrested, or when the force of uterine contractions are difficult to monitor indirectly.

A catheter inserted into a vein to administer fluids or medications or to measure pressure.

A catheter 12 to 13 in (30.5 to 33 cm) long, used to pass into a man's bladder.

A catheter inserted most commonly into the right side of the heart via the brachial, femoral, internal jugular, or subclavian vein for temporary pacing of the heart. The pacing wires or leads provide the electrical stimulus from an external source (a pulse generator).

A soft, flexible central venous catheter, inserted in a vein in the arm and advanced until the tip is positioned in the axillary, subclavian, or brachiocephalic vein. It may also be advanced into the superior vena cava. A PICC is commonly used for prolonged antibiotic therapy, total parenteral nutrition, continuous opioid infusion, or intermittent chemotherapy.

A rigid catheter used to suction the pharynx during direct visualization. Synonym: Yankauer suction catheter

A small chest catheter inserted between the parietal and visceral pleura and used to drain recurrent pleural effusions, e.g., in patients with cancer.

A catheter used for peritoneal dialysis that exits the chest instead of the lower abdomen. It is made of two silicone rubber tubes joined at the implantation site by a titanium connector that links its abdominal and presternal parts.

A catheter, 15 to 16 in (38 to 40.6 cm) long, with a short elbowed tip designed to pass prostatic obstruction. Synonym: elbowed catheter

A catheter inserted into the pulmonary artery to measure pulmonary artery pressures, pulmonary capillary wedge pressure, and, indirectly, left atrial pressure and cardiac output.

A bladder catheter designed to remain in place (e.g., a Foley catheter).

A catheter that permits direct urinary drainage from the bladder through the lower abdominal wall from a surgically fashioned opening located just above the pubic symphysis. Suprapubic urinary diversion is typically but not exclusively used as a temporary means of decompressing the bladder when the urethra is obstructed, e.g., in children with congenital deformities of the penis or urethra, or in adults with bladder outlet obstruction. When it is used for this purpose, it is considered a bridge before definitive surgery. See: suprapubic aspiration of urine; illustration

Patient care

The nurse observes for hemorrhage or prolonged hematuria and signs of local or systemic infection. Aseptic technique is used during dressing or equipment changes. Bladder irrigation is performed as prescribed. Medications, e.g., analgesics, antispasmodics, and bowel stimulants, are administered as prescribed. The patient's ability to micturate is evaluated. Intake and output are monitored and recorded. Fluids are forced unless otherwise restricted to ensure passage of dilute urine.

A central catheter containing three separate channels or passageways.

An intravenous catheter inserted into the subclavian or internal jugular vein and then advanced into the right atrium or superior vena cava. The proximal end is tunneled subcutaneously from the insertion site and brought out through the skin at an exit site below the nipple line. Commonly used tunneled catheters include the Hickman and Broviac catheters.

A catheter placed in the umbilical vein of an infant to facilitate administration of medicines parenterally or to do an exchange transfusion.

A catheter in sections to be fitted together so that it is flexible.

A catheter with little flaps at each side of the beak to help retain it in the bladder.

A rubber catheter with an inflatable balloon at its end, used to treat cysts or abscesses, e.g., Bartholin gland cysts in the vulva.