Hello again from the Emergency Procedures team. Next up…
Difficult male catheters
We recommend a Seldinger technique
So, without further ado…here is the video
How useful is this?
Very useful, if you can get hold of the right wire.
This should probably be the standard method of insertion in ED after a failed attempt.
The most recent study showed over 90 percent success after an initial failed attempt. Most clinicians were junior doctors with little experience. Additionally, no false passages were created. All failed attempts result in the soft wire curling back out of the urethral meatus.
How does this compare to using an introducer or a coudé tip catheter?
Introducers have higher rates of urethral injury, false passage and failure and are reserved for urologists.
Coudé tip catheters are sometimes used in ED, but they also have higher potential for complications.
After a failed attempt we recommend using a guidewire, and if this fails contacting urology for support
What type of wire do I need to order for my department?
A Straight hydrophobic guidewire such as:
- HiWire (Cook Medical)
- Radifocus (Terumo)
- ZIPwire (Boston Scientific)
I’ve spotted an improvement that could be made to your video and guide?
Don’t be shy, let us know! Drop us a line