Pediatric Foley Catheters
Foley Catheter
A Foley catheter is a flexible tube inserted through the urethra into the bladder to drain urine. In pediatrics, these catheters require special consideration due to anatomical differences and size variations in children.
Key Points:
- Material: Usually made of latex-free silicone to prevent allergic reactions
- Duration: Can be left in place for up to 30 days
- Sterility: Must be inserted using strict aseptic technique
- Monitoring: Requires regular assessment and maintenance
Catheter Sizes and Selection
- Premature Infants: 3.5-5 Fr
- Term Newborns: 5-6 Fr
- Infants to 2 years: 6-8 Fr
- Children 2-5 years: 8-10 Fr
- Children 5-12 years: 10-12 Fr
- Adolescents: 12-14 Fr
Balloon Volumes:
- Neonates and infants: 0.5-1.5 mL
- Children: 1.5-3 mL
- Adolescents: 3-5 mL
Common Indications
- Acute urinary retention
- Neurogenic bladder
- Perioperative bladder drainage
- Accurate urine output monitoring in critically ill patients
- Urologic procedures
- Management of hematuria with clots
Contraindications
- Suspected urethral trauma
- Acute prostatitis
- Known urethral stricture
- Recent urologic surgery (without specific instructions)
Insertion Procedure
- Position patient supine with legs frog-legged (infants) or lithotomy position (older children)
- Perform thorough hand hygiene and don sterile gloves
- Clean perineal area with antiseptic solution
- Use sterile drapes to create sterile field
- Lubricate catheter with water-soluble lubricant
- Insert catheter using anatomical landmarks:
- Males: Hold penis perpendicular to body, insert until urine flow
- Females: Spread labia, identify urethral meatus, insert until urine flow
- Inflate balloon with appropriate volume of sterile water
- Connect to drainage system
- Secure catheter to prevent traction
Common Complications
- Urinary Tract Infections (UTIs)
- Most common complication
- Risk increases 5% per day of catheterization
- Trauma
- Urethral injury
- Bladder neck trauma
- False passages
- Balloon-related issues
- Inability to deflate
- Balloon rupture
- Catheter obstruction
- Catheter encrustation
- Bladder spasms
Daily Catheter Care
- Perineal hygiene twice daily with soap and water
- Keep catheter secured to prevent movement
- Maintain closed drainage system
- Keep drainage bag below bladder level
- Empty drainage bag every 8 hours or when 2/3 full
- Monitor urine output and characteristics
- Document insertion date and planned removal date
Monitoring Parameters
- Urine output (age-appropriate norms)
- Urine color and clarity
- Signs of infection
- Catheter position and security
- Patient comfort and complaints
