hello so we are now going to observe
Juliet inserting a coude catheter for
the interest in the interest of
simplicity we're going to assume that
all nurses are going to use sterile
technique and we're not going to be
reviewing that as you can see Juliet is
prepping the penis using the betadine in
the circular motions very thoroughly and
again we're not going to be excessive
because it is a simulation materials we
don't want to ruin those we would use a
Euro jet because of his known history
and we could use a Euro jet for any
patient but we do have to order that in
advance I would open this year a jet and
drop it into the sterile field so that
it was ready for Juliet to use after she
had prepped the meatus so a few points
of emphasis Juliet's going to hold the
penis in a perpendicular position and
she is going to slowly insert that
you're the Euro jet the lady king jelly
into the meatus and down the urethral
tract she does use the whole thing and
the purpose of that is to again
lubricate the entire arethe roll track
you'll notice that she's got the penis
at 12 in a perpendicular location
and we would wait a couple of minutes to
allow for the light Akane effect the
anesthetic effect of that so a couple of
points of emphasis for the coudé
catheter when we go to insert the coudé
we would take that j' point the tip of
that and put it at 12 o'clock in
relation to how it is inserted and that
is the natural urethral tract again
going into the mail splatter the other
thing I want to point out is the
position of the balloon port would be
upright and when that is upright that
coude tip is upright so as you can see
at 12 o'clock we would put the tip in
that direction and then Juliet would we
would be telling Frank folie that we're
inserting now and for him to relax slow
deep breaths and Juliet if possible is
going to insert this catheter in our
simulation lab all the way to the hub if
it doesn't advance then that's okay but
the point is we would go down to the hub
we would have urine returned at this
point we would not force it it's like
every other catheter we could if we had
met resistance Julia what would we do if
we met resistance we would pull out
slightly right or or move the position
of the penis yeah it could have been be
slightly coiled or meeting resistance
and then try to advance it again so then
we would inflate our balloon
and we would gently let it slide back
out we would apply our stat lock before
we applied it to the leg and we would
prep our leg allowing for only one inch
of catheter tubing slack and in some
simulation lab it's actually this is too
loose this would not be a good position
and as you can see but that would be too
too loose we've only in real life only
have one inch of slack any other points
Juliet no it usually actually works very
well and then obviously the patient
feels immediate relief
you know when the Garen is is released
one point of emphasis if there you are
unable to accomplish this you would
contact the primary team and have a
discussion about the urology consults
that you would activate or the urology
guidance for the catheter insertion so
we wouldn't have other clinicians come
in and attempt an insertion if at North
iner side used a kuda catheter and been
unsuccessful we would go for that
consult we'd have that discussion with
the primary team and and activate that
urology consult
thank you very much Juliet thank you