foley catheter insertion

[butterscotch]

Licensed medical personnel inserting foley into 50 yr old male patient pre-op for emergent surgery (cardiac). Pt stable except for PCWP slightly low. No history of prostate enlargement or any urinary problems. Insertion of foley with sterile technique, no pain on insertion or with inflation of balloon with appropriate amt of sterile water, no problems with insertion, foley easily placed. No urinary return - it was assumed because pt "DRY" (Low PCWP). No evidence of blood at site or in urine bag at that time. Pt to OR - surgery postponed due to blood in foley - determined by urologist that foley placed in false lumen.

Question - Should the balloon of foley catheter have been inflated? If there is no immedicate flow of urine in a "dry" patient do you inflate the ballon and leave the foley in or remove it? Remember there was no c/o pain from pt, no difficulty in placing of foley, low PCWP, no signs of trauma after insertion.

[Kevin Pho, MD]

I am not a critical care physician nor nurse, so my experience with this question will be limited.  

Even if the wedge pressure is low, there should be some urine return.  If there is no urine return, then I probably wouldn't inflate the balloon, as the foley may not be in the right position.  

If there is no urine return, one option would be to irrigate the catheter, seeing if there is appropriate return of the fluid.  

If there was truly a "false lumen" and this was done during an emergent situation, the resulting situation may have been difficult to avoid.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[marianita]

A related discussion, living with an indwelling foley catheter - female was started.