Urinary catheters are placed most frequently in Emergency Rooms. When difficult catheterisation is encountered, lack of immediate specialist services can transform a simple procedure into a stressful emergency. Repeated attempts can lead to urethral injury with the risk of severe bleeding and urinary sepsis. We evaluate a new catheterisation algorithm in the acute care setting which provides frontline healthcare professionals with a purpose-designed Plan-B catheter with integrated guidewire to solve a difficult catheterisation episodes in a rational and cost-effective way to improve patient care.