when male patient pulls his foley out

EmmaG, RN · Oct 27, 2007

my patient didnt have any urine output because of bleeding, and all of a sudden patient had coffee ground emesis. i'm asking this because i've heard of patient vomitting feces and bm coming out of patient's tracheostomy. :uhoh21:

a fistula tract between the esophagus and trach would explain that, however blood from the urethra/bladder is not going to be vomited up. i'm racking my brain to think of a scenario where it could happen, and i can't come up with anything...

just out of curiosity, what is the patient's diagnosis and co-morbidities? does this patient happen to have a history of etoh?

vamedic4, EMT-P · Oct 27, 2007

what do you guys usually do when a male patient pulls his foley out and he is bleeding where the foley is inserted?

one of my first patients in my clinical rotations years ago in the icu did just that, and yes, the balloon was still inflated. i reached between my legs...let out a moan:uhoh3:...ugh...and proceeded to reinsert another catheter...all the while thinking "omg, this poor man!"...

i pray that never happens to me. bad enough a few years ago when i had my surgery (vp shunt replacement) they gave me morphine for pain...so of course i couldn't "go"...and they decide to do an i/o cath...no problem, right? that was until i saw the size of the catheter...i'd swear it was the size of my garden hose!! :eek: :eek:

needless to say, being cathed was no fun, but i was very glad to be relieved of 1600cc of urine.

vamedic4

Valanda · Oct 27, 2007

When I was in Texas and we had male patients (generally only the confused ones) who regularly pulled out their foleys we used a method similar to a Texas cath. Foley inserted through small hole in tip of condom, foley inserted into male patient's bladder, (no balloon inflation), condom in place over member, condom taped to foley at tip, spiraled 1/2 inch tape up the outside of the condom. It seemed to work really well. We resolved the problem of foley's coming out with the ballon intact. I have not seen this done since I left TX nearly 12 years ago, but the urologist in Houston was adamant about being sure we all knew how to do this "just right" to prevent circulation problems yet keep the catheter in place.