Austere Conditions: Urinary Catheterization
Austere Conditions adaptation of: Insertion of urinary catheter for urinary retention, monitoring, or specimen collection.
Indications
Acute urinary retention, output monitoring in critically ill, urological procedures.
Contraindications
Urethral trauma, urethral stricture (use suprapubic route).
Equipment Required
Standard Equipment
Foley catheter, catheterization kit, sterile gloves, lubricant, drainage bag.
Lunar Medical Bay Substitutions
Standard plus: drainage bag must be secured to bed/wall — urine will not flow by gravity in 1/6g. Use sealed drainage system with manual pump if gravity drainage insufficient. Maintain strict aseptic technique — CAUTI in lunar habitat is serious infection with limited treatment options.
Procedure Steps
Informed consent. Sterile technique. Clean meatus. Insert lubricated catheter into urethra until urine flows. Inflate balloon. Connect drainage. Secure to inner thigh.
Lunar Technique Modifications (1/6 Gravity)
DRAINAGE IN 1/6G: Urine bags must be positioned and periodically emptied — gravity drainage unreliable. Use bellows-type drain or suction-assisted drainage. Empty bag every 2 hours. Assess for adequate drainage by palpation. Standard female catheterization: positioning on back unchanged. Male: ensure adequate stabilization against 1/6g float.
Telemedicine Guidance Points
Contact Earth Medical Relay (+1.3s delay) at these critical decision points:
Consult for catheterization difficulty. Any suspected urethral injury. Persistent hematuria through catheter.
Training Requirements
Medical officers: catheterization competency.
Possible Complications
Infection, urethral trauma, bladder spasm.