So I had 2 cases of bleeding noted in the Foley Cath. We also noted bleeding around the penile area. However, after penile care was done, no bleeding was noted around the penile area after. So the problem must be inside the urethra.
With the first case, after flushing it with NS twice per shift as ordered, the urine became clear yellow again. No bleeding noted in F/C after.
The second case, frequent flushing didn't stop the bleeding. The D.O.N then told us to flush with cold saline. So they put the saline in the refrigerator for 30 min - 1 hr, took it out and irrigated the F/C with it. I have never heard of this practice before: flushing with cold saline to stop the bleeding. I thought we should never flush F/C with cold saline since it might cause bladder spasm?
I've never been in an acute setting hospital and these nurses that agreed to flushing it with cold saline got this method from their experience in an acute care hospital.
May 9, '13
I've never heard of that either. It seems like that could cause clots that would occlude the tubing. FWIW, I just googled it and found an article on eHow.com (which I realize is not a medical forum, but they cite their references as medical sources) about how to flush a foley and it says never to use cold solution:
Also, how did the patient take it? Brrrr....!!!!
Last edit by westieluv on May 9, '13
May 9, '13
I spent 10 years on a urology floor and NEVER would i think of using cold saline. Frequent bladder irrigation for clots is the best.
May 10, '13
Irrigation is enough. I can see her rationale being cold water might help a bit with vasoconstriction though.
May 10, '13
It think the doctor should be called for what "type" of saline to use. Not the DON's decision to make.
I imagine it would be quite uncomfortable for the pt to be irrigated with the chilled fluid.
May 11, '13
I think you guys misunderstood me. We flushed cold saline for the purpose of vasoconstriction, not to flush out clots. This pt was on lovenox before too... So he bled excessively anytime there's a small trauma... Well the result wasn't so well. We couldn't stop the bleeding even with all the cold flushes and he had a change of condition, so we had to send him out of our facility to an acute care hospital. This was the first time I saw this practice so I was wondering if this is common... If this is a nursing intervention or do we have to get md order for this kind if intervention.