Hi, I'm Randy Golden of Medical Technologies of Georgia, and I'm here today to show you the clinical and service procedure for MTG EZ-Advancer closed-system intermittent catheters. In this demonstration I'm going to be showing the correct procedure to do EZ-Advancer, MTG's firm vinyl catheter.
We also make a soft version of this product should you have patients with sensation. We offer female length catheters as well as coude tip, and all MTG products are 100% latex-free. MTG's catheters eyelets or drainage holes are fire polished, so they are less likely to cause irritation as the catheter winds its way through the urethra. We also have a conical tip which helps the catheter pass through tight spots along the way.
Now let's have a look at EZ-Advancer. Keep in mind the last two numbers in the reference number are the French size, in this case, 14 would denote a 14 French catheter.
First, I'm going to show a demonstration of how to catheterize the male patient. Before catheterizing, always wash your hands, explain the procedure to the patient, verify the French size, and insure that the catheter tip is the correct variety.
MTG EZ-Advancer catheter kits are packed in chronological order so that a sterile catheterization is absolutely possible. We include the cuffed, folded latex-free gloves, which we will go ahead and don first. After donning gloves, the next kit component we'll find is the under pad. And you want to place the under pad shiny side down, paper side up, on the patient's legs, with the anatomy above in the middle, just like so.
OK, the next kit component, after we place the under pad, are the benzalkonium chloride swab sticks. There's three of them in here, these are antiseptic, and you basically just tear the top of the package off, and remove the three swab sticks, and I like to just take them entirely out of the package, and set the pack back in my sterile field. At the same time, I take the catheter with my other hand and remove it from the kit. Now, you remove the cap, and expose the Introducer Tip, and I'm just going to discard the cap, set is aside there, and I'm gonna place the closed-system catheter also back in my sterile field with the Introducer Tip inside the tray, so that again it remains sterile.
So now we're ready to go to the patient. So the first thing I'm going to do is I'm going to pull the foreskin back with my last three fingers of my left hand. I'm right-handed and all the advancement of the catheter will be done with my right hand. I'm going to use the left hand to stabilize the penis. And notice here that I'm freeing up my thumb and my index finger and I'll explain what they are going to be used for in just a second.
Now, go back and get your swab sticks, and go right over the urethral opening and around the glans, one time, with each swab. This cleans the area out, around the glans, and you'll notice too, the benzalkonium chloride is clear as opposed to the iodine products so we don't end up with a big mess.
Now once we've prepped, without letting go of the patient, I'm going to reach back for our catheter. And again, it's all pre-lubricated. I'm going to insert the catheter and the Introducer Tip in the urethra just like this. It should look just like this in the patient as it does in my model here. And now, my thumb and my index finger, I'm going to use to just stabilize everything so I can let go of the patient with my right hand entirely.
And all I have to do now is go back to the catheter and the bag, the bag is just graduated and at the 1400 cc mark is about a good place to start. I'm going to just advance the catheter one to one and a half inch intervals. Advance in. And again, I'm not squeezing anything because that locking mechanism I described earlier, notice how easy the bag is to push back. Insert in, straighten the bag, insert in, straighten the bag, insert in, straighten the bag.
Now let's assume that we reach the prostate, and you're having a little trouble advancing the catheter further. If the patient is awake, you might ask him to take a deep breath, and certainly don't force the catheter in, let's wait until we have a chance to pass the catheter without forcing it in. He takes a deep breath, we pass the catheter one more push and get the catheter right in the bladder. And then one more push to get the catheter in the middle of the bladder.
Straighten the bag, and now urine will start to flow. When the patient finishes voiding, take the catheter again at that 1400 cc mark, and grab tight here, and just pull the catheter out, about one inch. See if we have any more fluid.
And you notice I've let go of the patient. I don't have to hold on to the anatomy any longer, I'm going to reach back and grab the gauze tissue in the kit, and I'll show you what the purpose of the gauze tissue is now. As the catheter leaves the body, you want to catch the eyes of the catheter with the gauze tissue to avoid any spilling.
Clamp off the eyes just like so, hold it up so we don't have any spilling. Incidentally, if you let go of the bag, it's not going to separate, we have a flange in there that keeps everything together so it won't end up on the floor.
Now, we go over to the toilet, how do we get the urine out of the bag? Well, entwine the catheter the gauze tissue just like I'm doing here, go over to the toilet, now if we need a sterile sample, this is the other nice trick. Hang on to the pipe inside the bag, and with just a gentile tuck here, pull the catheter out of the top of the bag, and expose the sterile sample port. As long as I don't touch the lip here, the port is sterile and you can pour a sample off for the lab.
Now let's have a look for the catheterization procedure for women.
I'm going to show everybody the EZ-Advancer, but we also make a product specifically for women called MTG Cath-Lean, and there is information about this product on our website.
So now, let's take a look at catheterization of the female using the anatomical model. I've gone ahead and donned my gloves, I've opened up the swab package and got them ready to go, and now I'm going to go to the patient, and I'm going to spread the labia with the two fingers of my left hand, just like so.
And, just like before, I'm going to use my right hand to do all the advancements. I'm going to take each swab and I'm going to start right above the urethral opening, and wipe downward, one time, with each swab. Don't retrace the same skin with the same swab stick. Again, there's no iodine so it's less messy for sure.
Now, take the catheter at the 1400 cc mark and insert the catheter and the Introducer Tip in the urethra just as I'm doing here, OK, and use those two fingers to keep everything stable. Now notice here that I'm straightening the bag, I want to make sure that the bag is parallel with the legs with the MTG logo up, reason being, that once she starts to void I want the urine to go down into the bag, and I want to be able to see the urine flow. Another helpful hint here is to pull the catheter as far up into the bag as you possibly can just like so.
And now, I'm ready to advance the catheter at one to two inches at a time. With the female you only have to put it in about two pushes before the catheter reaches the bladder. And then one more push once we see urine to get the catheter right in the middle of the bladder.
And then straighten the bag out, position the bag between the patient's legs just like so, and the urine will pool down here at the bottom of the bag. Once she discontinues voiding, pull the catheter just like we did in the male example, and pull the catheter out about one inch and see if we have any more fluid, reach back into the kit, and get that gauze tissue, and as the catheter leaves the body, use that gauze tissue to catch the eyes so we don't have any spilling.
Clamp the eyes off, extend the catheter all the way to the end, measure and record output. If you need a sterile sample, just as before, use the gauze tissue and entwine the catheter, go over to the toilet, look away, pull the catheter out of the top of the bag, and we have finger holes here too, which can be used to help drain the bag.
Finally, when you are all finished, put everything in one hand, take your first glove off, second glove off, and you never come in contact with the patient's fluids either.
It’s very important when removing the cap from either EZ-Advancer or Cath-Lean that we gently pry the cap off the Introducer tip in this manner. Let me do this again, and I’ll show everybody. So the cap is secure. When you take the cap off, gently pry it away, just like so. What you don't want to do, you don't want to pull the cap in an upward manner as I'm doing here. And the reason we say that is you want to make sure that the Introducer tip is not removed from the bag. So again this one here, this one in my left hand is correct. I'll show you one here that we have taken the Introducer tip completely off of. The one in my right hand you would not want to use. You can actually look down inside and see that the Advancer valve is exposed. The Introducer tip is removed. If you encounter a bag where you've taken the Introducer tip completely off, discard this one, and get another.
Thank you for watching our video today. For more information about MTG catheters, please visit our website, MedTechGA.com, where you can learn more about all of our products, as well as order free samples for your patients.