An elderly male being prepped a-fib ablation.Intubated, sedated - during foley catheter placement he developed trauma of his urethral tract.Rn inserting 16f catheter which advanced into urethra without resistance, but rn did not note a urine return.Catheter removed slightly and rn noted blood in catheter as well as blood surrounding catheter.Rn stopped removal and called doctor from urology to assist.Md removed initial catheter and inserted coudé.Patient transported to post-anesthesia care unit (pacu); patient educated on events.Urology: patient has urethral tear.Urology consult noted : patient had a 16 french silicone catheter in the urethra with the catheter having curled in the tip coming out of the meatus.This was carefully removed.A urojet was then used to instill and fill the urethra with lidocaine jelly.A 16 french coudé-tip catheter was then used and with several manipulations was eventually able to be advanced into the bladder.Clear yellow urine drained at that time.Balloon was inflated and the catheter was put to drainage bag.At that point there was no active bleeding from the urethra.
|