If the catheter is left in place for a longer period of time, encrustations often form in bladder catheters, triggered by salts and chemical processes of certain types of bacteria that are found in the so-called “biofilm” of the catheter lumen. The probability of bacteria occurring increases with the length of time the catheter is in place. The presence of bacteria in the urine (bacteriuria) is almost unavoidable in patients with permanent urinary diversion, which is why the risk of incrustations and subsequent blockages also increases. In 40 to 50 % of all patients with bladder catheters, complications occur due to blockage of the catheter by deposits and incrustation. (European Association of Urology: Evidence-based Guidelines for best practice in Urology Health Care. 2013)

Components for a cleaning process

The CaDo system consists of 2 components, the CaDo device and the CaDo working insert. Both are required for successful catheter cleaning. The CaDo device is supplied in a sturdy storage box. All catheter cleaning steps are accompanied by a colorful, easy-to-read display. This makes it easier to carry out the instructions.

The CaDo device is equipped with a lithium-ion rechargeable battery, which should allow at least 10 cleaning procedures without recharging. The charge status of the battery is shown on the display. If the battery capacity is too low, it is possible to operate the appliance from the supplied power supply.

The CaDo working insert is a sterile article for single use and consists of the cleaning wire with an innovative cleaning head, a T-piece to connect the catheter and device and a urine bag to collect the accumulated urine after successful cleaning. The user is always protected against urine reflux.
After removing the single-use product, the catheter can be reconnected to the permanently used drainage bag. The working insert can be used with catheters of different sizes.

Step 1: Preparing the patient

The patient should be in the lying position. A suitable support surface (e.g. an absorbent pad with a rubberized back) ensures clean working and the most straight positioning of the catheter to be cleaned.

First, try flushing the bladder catheter with a sterile 0.9% NaCl solution. If the flushing fluid can be introduced into the catheter and aspirated again without any problems, the CaDo system should not be used, but a doctor should be contacted if necessary. In this case, the catheter is not blocked.

Step 2: Commissioning the CaDo system

The next step is to prepare the CaDo device. Remove the CaDo device from the transport box and switch the device on. The device will now carry out a self-test. If the display shows “Ready”, the device is ready for use. Now place it back in the open transport box.

Step 3: Preparing the work insert

Please use gloves during preparation. Remove the connection of the catheter bag from the cone of the indwelling catheter.
First try to make the catheter accessible again by flushing it. If flushing is successful, the CaDo system does not need to be used.

First remove the disposable material from the outer packaging. Put the drainage bag to one side and grasp the sterile-wrapped working insert with both hands. Remove the upper end of the perforated sheath with a jerk. The working wire with cleaning head is now exposed.
Insert the end of the wire directly into the catheter. Remove the rest of the sterile outer packaging. Push the wire far enough into the catheter so that you can attach the cone of the T-piece to the catheter. Once the T-piece is attached to the catheter, feed the wire end protruding from the other end of the T-piece up to the mark. Attach the drainage bag to the lower connection of the T-piece and place everything on the prepared surface. Now the work insert is ready.

Step 4: Connecting the CaDo device and work insert

Push the end of the wire protruding from the T-piece through the metal cone of the CaDo device into the device until the wire clicks into place. Now insert the metal cone of the CaDo device into the free end of the T-piece. The CaDo system is now ready for use.

Step 4: Connecting the CaDo device and work insert

Push the end of the wire protruding from the T-piece through the metal cone of the CaDo device into the device until the wire clicks into place. Now insert the metal cone of the CaDo device into the free end of the T-piece. The CaDo system is now ready for use.

Step 5: Cleaning the catheter

Hold the device in your hand for approx. 10 seconds during the cleaning process to ensure that the catheter runs as straight as possible. Press the start button on the CaDo device. The cleaning process now starts automatically. The cleaning steps are shown on the display. At the end of the cleaning process, “Ready” appears on the display, you will hear an acoustic signal at the same time and the cleaning insert is released in the device.

Disconnect the CaDo device from the T-piece and pull the working wire back as far as it will go. The accumulated urine can now drain into the urine bag attached to the T-piece. In the meantime, switch off the CaDo device and store it in the transport box.

When no more urine runs out, you can remove the T-piece from the catheter and replace the original urine bag. Dispose of the single-use material in the household waste. For patients with problematic germs, the material must be disposed of with the infectious care waste.

Cleaning the CaDo device

We recommend wipe disinfection after each use of the device. To do this, spray a thin layer of a commercially available disinfectant for surfaces with a pump sprayer. Leave it to work for at least 5 minutes and then wipe the device with a dry, lint-free cloth.

Avoid running water and do not submerge the device into water for cleaning.

Under normal circumstances, it is not necessary to clean the transport box after using the CaDo device. However, under increased infection control conditions, this can be done in the same way as for the device by wipe disinfection. The transport box cannot be autoclaved.

Cleaning of the catheter is now complete and the CaDo system is ready for further use.

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