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Nephrostomy change

No change in size, 13:43, 2 July 2019
*Insert the new catheter with obturator over the guidewire, keeping the same direction as the guidewire through the tissues to avoid pulling or kinking it.*
*Enter the renal pelvis with the obturator, and then advance with only the soft catheter.*
*If proper position of a pigtail catheter, lock the pigtail. If unsure, confirm location within the renal pelvis by injection of a few ml of contrast before fixation, with two projections from different directions.**Confirm functionality by injection of a few ml of contrast, with two projections from different directions, looking for spontaneous dripping from the catheter when left open, as well as aspiration of the contrast.* <br>Check whether there is blood or pus in the aspirate or spontaneous return.
*Attach the outside end of the catheter to a bag.<ref group=notes>Plug it only if there is a clear plan to attach a bag at a specific later time.</ref>
*Fixate the catheter to the skin, preferably both directly at insertion as well as enough to the side to have a soft S-shaped bend of the catheter in order to give certain room for stretching without pulling out the catheter.
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