Catheter Removal: OSCE Station Checklist

Catheter removal is a short procedure with one hard rule and one long tail. The rule: the balloon deflates completely before anything moves. The tail: the job isn’t finished until the patient proves they can pass urine without the tube.

The sequence:

1. Confirm the removal order and check the insertion record: catheter type, balloon volume (commonly 10 mL), date inserted.
2. Hand hygiene, identity, explanation, consent. Warn honestly: brief stinging is common.
3. Privacy: curtains, minimal exposure, patient supine and relaxed.
4. Gloves and apron. Place an absorbent pad under the patient.
5. Attach a syringe to the balloon valve. Let the water return; aspirate gently if needed. Check the volume against the record.
6. Volume correct? Ask for a slow breath out, withdraw smoothly and gently.
7. Inspect the catheter: complete, tip intact. Note the urine in the bag (volume, appearance) before disposal.
8. Clean, cover, dispose, gloves off, hand hygiene.
9. Set up the trial without catheter.

The balloon scenarios

The station’s planted problem is nearly always the balloon. A syringe that returns less than the documented volume means a partly inflated balloon, and the only safe move is stopping: reposition, retry gently, escalate per policy. The banned improvisations, pulling anyway, cutting the valve or catheter, injecting more water, are each a real incident from real practice, which is why they populate the wrong-answer options. “I would not cut or force anything; deflation failure gets escalated” is a sentence worth saying even in a smooth run.

The trial without catheter

Removal succeeds when voiding resumes, not when the tube exits. The TWOC plan: encourage oral fluids, record the time and volume of the first voids, and watch for retention: no urine over the policy’s window, suprapubic discomfort, a distending bladder. Retention is an escalation, not an observation. Saying the plan to the patient (“drink normally, use this jug so we can measure, call us if you can’t go or it hurts”) covers the communication and the aftercare marks in one breath.

Documentation carries the safety story: balloon volume returned, catheter intact, tolerance, urine noted, TWOC started. Each item is a line the examiner can tick, and none of them can be ticked if they only happened in your head.

Five questions below, then the assessment trio begins with wound assessment.