Question

You're preparing for urinary catheterization of a trauma patient and you observe bleeding at the urethral meatus. Which action has priority?

A. Irrigate and clean the meatus before catheterization.
B. Check the discharge for occult blood before catheterization.
C. Heavily lubricate the catheter before insertion.
D. Delay catheterization and notify the doctor.

Answer 1

When observing bleeding at the urethral meatus before urinary catheterization of a trauma patient, one should delay catheterization and immediately notify a doctor to prevent exacerbating potential urethral injuries.

Step-by-step explanation:

Observing bleeding at the urethral meatus during preparation for urinary catheterization in a trauma patient is a significant finding that deserves immediate attention. The presence of blood could indicate a potential urethral injury or trauma, which is why the priority action should be to delay catheterization and notify the doctor. Continuation with the catheterization without proper assessment by a physician may exacerbate the injury and lead to serious complications.

While cleaning the meatus or checking for occult blood could be part of the evaluation process, and lubricating the catheter might normally reduce friction during insertion, none of these actions take precedence over ensuring the patient does not have a serious underlying injury. Therefore, it is critical to halt the procedure and consult with a physician for further evaluation and potentially an alternative method for urinary drainage, such as suprapubic catheterization, if urgent drainage is required.