Unconsciousness occurs when a person is unresponsive to the outside environment, such as voices or shaking. The condition can be temporary, such as when someone faints, or more prolonged, like in surgical anaesthesia or a coma. An unconscious person is alive and looks like they are asleep, but unlike a sleeping person, they cannot be awakened by noise, motion, cold water or even pain. In severe cases, the unconscious patient may even stop breathing or have weak life signs.
Unconscious patients are unable to control how/when they empty their bladders due to their condition. They also can’t signal their intention to urinate to a caregiver, which makes the situation more unusual than other cases of dysfunctional bladder management.
Bladder management of unconscious patients with catheterisation
Due to the unresponsiveness and immobility of long-term unconscious patients, some of the usual methods of catheterisation that require constant movement and frequent changes are not suitable to them. These include external and intermittent catheters.
An external catheter, aka a condom catheter or a male catheter, consists of a sheath made out of PVC, latex or silicone, with an adhesive to attach it to the penis, and the standard tube coming out of the other end, connected to a drainage bag. An intermittent catheter is a form of self-catheterisation where the user inserts a single-use catheter through the urethra into the bladder to urinate as and when necessary.
For unconscious patients, the more suitable options usually involve more long-term catheterisation via:
- Indwelling urinary catheter – A catheter is inserted into the bladder through the urethra, with an inflatable balloon end to keep the catheter in position at the bladder, while the outside end of the catheter leads to a drainage bag. These can last up to twelve weeks and is also known as a Foley catheter.
- Suprapubic catheter – Where urethral insertion is not feasible, this method involves passing a tube surgically through the abdominal wall directly into the bladder without going through the urethra. This needs to be replaced every six to eight weeks.
Risks of urinary tract infection from catheter use
While catheters are invaluable for managing the bladders of long-term unconscious patients, there is an increased risk of infection to the urinary tract with prolonged use, as the tube introduces bacteria or fungi access to the bladder over extended periods. The microbes can multiply and lead to what is called a Catheter-Associated Urinary Tract Infection (CAUTI). One of the most common infections a person can contract in the hospital, indwelling catheters are a major cause of CAUTI although they also occur with suprapubic catheter use.
CAUTI can be especially dangerous for unconscious patients as they are unable to report any discomfort or illness they feel, and are reliant on their caregivers to detect any infections or complications that arise out of catheter use.
How UroShield can help lower risks of CAUTI
With indwelling and suprapubic catheters, the risk of infection greatly undermines their utility in bladder management. However, there is a non-invasive way to reduce the chance of infection.
UroShield is a compact external medical device that generates low-frequency, low-intensity ultrasound waves to prevent bacterial biofilm from forming on catheters. The action of the ultrasonic waves runs along the full length of the catheter, up into the balloon and down into the bag, both on the outside and inside surfaces of the catheter. The ultrasound gently vibrates the catheter to stop the bacteria from adhering to the catheter and forming the biofilm – preventing infections from developing.
If biofilm is present, UroShield helps to break up the protective layer surrounding the biofilm which is normally impenetrable to antibiotics, allowing it access to the bacteria and curing the infection. The vibrations also prevent catheter encrustation and blockage, caused by crystalline deposits of mineral salts in the urine. UroShield also helps to reduce catheter-associated bladder spasms and pain and is effective for any kind of catheter, both urethral and suprapubic.
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This post is not health advice and should not replace professional advice tailored to your specific circumstances. It is intended to provide information of general interest about current healthcare issues.