›Sterile technique
›Stop if severe pain or resistance
›Catheter replacement
›Replace if blocked
›Consider coude catheter in BPH
›Suspected urethral injury pathway
›Stop repeated attempts
›Urology consultation for guidewire assisted placement local protocol dependent
›Suprapubic catheter issues
›Assess tract maturity
›Avoid blind reinsertion if immature tract
›Urgent urology if dislodged with urinary retention
Antibiotics and symptom control
›Treatment options
›Suspected CAUTI without sepsis
›Replace catheter if long term catheter in place
›Antibiotics guided by local antibiogram
›Example adult regimens local protocol dependent
›Ceftriaxone IV 1 g daily
›Piperacillin tazobactam IV 3.375 g every 6 hours
›Ciprofloxacin PO 500 mg every 12 hours
›Avoidance reminders
›Avoid nitrofurantoin for suspected pyelonephritis
›Avoid fluoroquinolones when safer alternatives exist in high risk tendinopathy populations
›Pain and spasm control
›Acetaminophen PO 1000 mg every 6 hours maximum 4000 mg per day
›Ibuprofen PO 400 mg every 6 hours if renal function adequate and bleeding risk acceptable
›Oxybutynin PO 5 mg up to three times daily for bladder spasms if no contraindication
›Hematuria management
›Hold anticoagulants only with clear indication and prescriber alignment local protocol dependent
›Three way catheter and irrigation for clots
›Transfusion threshold based on symptoms and hemodynamics local protocol dependent
›Iterative monitoring
›Recheck after interventions
›Pain score
›Urine output
›Vital signs
›Repeat focused exam
›Suprapubic distension
›Flank tenderness
›Escalation triggers
›Persistent anuria
›Worsening vitals
›Rising creatinine
›Recurrent clot retention