Lamont et al reported a decision flow diagram for suprapubic catheterisation of an adult patient. This was adapted from Harrison et al. The authors are from the National Patient Safety Agency in the UK.


Decision points:

(1) Does the patient have clear indications for suprapubic catheterisation?

(2) Are there any contraindications to the procedure?

(3) Will the procedure be performed by someone who is adequately trained and/or supervised?

(4) Is the patient in distress?

(5) Does the patient have a history of previous abdominal surgery or other cause for intra-abdominal adhesions?

(6) Is the urinary bladder palpable?

(7) If unpalpable, can the bladder be localized by ultrasonography?


The procedure should not be done if:

(1) there are no indications for it to be done

(2) there are contraindications

(3) the operator is not adequately trained


Bladder aspiration should be performed if the patient is in distress and the procedure cannot be done for one or more of the reasons listed.


Ultrasonography or an open procedure should be considered if:

(1) the bladder cannot be palpated

(2) the patient has a history of previous abdominal surgery or adhesions

(3) bladder filling is to be attempted prior to catherisation


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