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Immediate stabilization
Stabilization priorities
Airway and breathing compromise
Altered mental status
Respiratory failure
Circulation threats
Hypotension
Shock physiology
Time critical triggers
Suspected sepsis from urinary source
Suspected obstructive uropathy with acute kidney injury
Suspected cauda equina syndrome
Initial actions
Bladder decompression pathway
Immediate catheterization for painful retention
Urology escalation if failed passage
Monitoring
Vital signs trend
Urine output after decompression
Analgesia and comfort
Topical urethral anesthetic
Systemic analgesia for severe pain
Key decision points
Risk stratification
High risk features
Fever
Flank pain
Rigors
Hypotension
New neurologic deficits
Obstructive complications
Hydronephrosis suspicion
Post obstructive diuresis risk
Traumatic catheterization risk
Blood at meatus
Pelvic trauma
Recent urethral instrumentation
PEARLS
Practical pearls
Bladder scan before catheter if uncertain diagnosis
Low bladder volume with inability to void suggests anuria rather than retention
Catheter drainage monitoring after decompression
High volume output with ongoing polyuria suggests post obstructive diuresis
Avoid repeated blind attempts if resistance
Urethral injury risk
Early urology involvement
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.