Intensive Care Medicine (ICM) Practice Exam

What type of disinfection is primarily used before inserting a urinary catheter in females?

1. Saline solution

2. Iodine solution

3. Chlorhexidine solution

4. All of the above

The correct answer is: All of the above

The primary goal of disinfection before inserting a urinary catheter is to reduce the risk of introducing pathogens into the urinary tract, which can lead to catheter-associated urinary tract infections (CAUTIs). Various antiseptics can be used for this purpose, and several options are effective. Iodine solutions, particularly povidone-iodine, are widely recognized for their antiseptic properties and are often employed in clinical settings to effectuate skin antisepsis due to their broad-spectrum action against bacteria, fungi, and viruses. Chlorhexidine is another potent antiseptic that has gained favor for its sustained antimicrobial activity even after application. It can significantly decrease the bacterial load on the skin, making it a common choice in urinary catheterization preparations. Saline solution, while useful for cleansing, is not strictly an antiseptic and does not have the same antimicrobial properties as iodine or chlorhexidine. However, it could be part of a pre-procedure cleansing routine and may facilitate the removal of debris or blood from the insertion site. In practice, the use of more than one type of disinfection agent can be beneficial for optimizing the sterility of the procedure. Therefore, it's acceptable to incorporate multiple solutions, including saline, iodine, and chlorhexidine, in