Urinary Cath Insertion

[lovecardiacnursing]

Has anyone ever blown up the balloon on a catheter while it was still in the urethra? If so, what happened?

I had an incident recently where a male patient was having hematuria with clots, the clots had stopped for about 8 hours so the doc DC'd the continuous irrigation. The 3-way cath was to be pulled the next morning (20 hours later) as long as there were no complications through the night. I came back the next day and DC'd the 3-way. After 6 hours he was still unable to void and bladder scan showed he was full--called the doc and he ordered a coude to be placed. Another nurse and I put it in (or so we assumed) with ease and no c/o pain from the patient; however we didn't get any urine return. This was a huge red flag for me because to me that's the only way to know its definitely in the correct spot. The other nurse thought the tip may be clogged by the lubricant or by a clot, so she filled the balloon. We flushed the cath and still no urine. I called the doc and explained and he said he was coming in. Long story short, turns out it was at the prostate and not in the bladder (my original fear with no urine present)--and the balloon was blown up. It's still amazing to me that the patient never complained of pain, it's not like he was a stoic man either. I've never had this happen before and it's really upsetting me, so I'd love to hear any of your experiences or thoughts.

[nurseprnRN, BSN, RN]

I was taught this way in nursing school. It seems like the safest method. Is there a reason it isn't taught as common practice across the board? Perhaps higher risk of the longer Foley touching the bed or something?

This is why we teach sterile technique. If you have good control of the Foley while you're handling it, this will not be a problem.

[FlyingScot, RN]

Watched a resident do this to a neonate. Tried to stop her but she told me she knew what she was doing. Destroyed that little girl's urethra. She required major surgery to repair the damage.

[torilexington]

I do this every time when dealing with a urinary catheter. I do that when I insert one of the foley's in the male. Sometimes they have pain and sometimes they don't. I've seen it go both ways.