PureWick Use, Warnings, & Precautions for OT

UPDATE: I have been seeing more of this happening at my work. As mentioned by the manufacturer: “Do not use with bedpan or any material that does allow for sufficient airflow”. Mesh type underwear should be fine since they have holes for airflow.

Update 11/9/2020: I spoke with Bard, the manufacturer of PureWick and they said that the use adult briefs (“diapers”) are fine. Personally, I would just make sure to change the adult briefs (if used in conjunction) and the PureWick often as I have seen fecal matter reach the PureWick and perineal area and that is probably not good for UTIs.

Often, I encounter this device in acute care. The first time you encounter this device, you will probably have an interesting reaction. Sometimes, you may not even notice the Purewick until you begin to mobilize the patient.

The purewick is an external female catheter type device that is often connected to the same tubing as oral suction. Yes, it is often the same suction collection type canister above the patient’s bed, with the urine exposed for the world to see. Lately, there has been a lot of PSA about it due to inappropriate use with patients. Most notably, purewicks have been found innapropriately taped to the patient’s groin. According to the manufacturer:

Indications

“The PureWick female external catheter is intended for non-invasive urine output management in female patients.”

Caution

  • Contains dry natural rubber

Contraindications

  • Urinary retention

Warnings

  • Do not use with bedpan or any material that does allow for sufficient airflow
  • Never push or pull against the skin during placement or removal
  • Discontinue use if allergic reaction occurs
  • Product is biohazard (as is the output in the suction canister). Dispose of according to regulations.

Precautions

  • Not recommended for agitated, combative, uncooperative patients who may remove the device.
  • Not recommended with frequent bowel incontinence without fecal management.
  • Not recommended with skin breakdown, irritation, or menstruation.
  • Do not use a barrier cream on the perineum, as it may impede suction.
  • Not recommended for patients with known latex allergy.
  • Use caution with patients who have had recent external urogenital tract surgery.
  • Maintain suction until fully removed to avoid urine backflow.

Recommendations

  • Replace every 8-12 hours or when soiled with feces or blood.
  • Suction of at least 40 mmHg.

OT Dude’s Tips

  • When mobilizing patient and temporarily disconnecting the purewick, you can place it in a clean glove. Yes, it is not sterile, but it is probably better than leaving it out exposed. If anyone has any other tips, feel free to let me know and I will share them.
  • PureWicks are often used for patients with urinary frequency so if you have the opportunity to assist the patient with toileting before/during/after your session, do it.
  • If you see a canister that is the color of urine, with tubing connected to the patient, they likely have used a purewick or currently have one.
  • Sometimes when patient urinates, the purewick does not fully collect all of the output. You may still want to use incontinence underpads.
  • If adult briefs (diapers) were used, be sure that the purewick has good airflow and does not make a strange “plugged up” sound which doesn’t allow the device to function properly.
OT Dude
Jeff is the lead writer and content creator for OT Dude and covers all things Occupational Therapy. Buy him a coffee: venmo @otdude