Ok, I tried to do a search on this as I am sure that this topic has been debated before, couldnt find anything...got tired of looking. When irrigating a foley catheter do you use sterile water or normal saline?
Most of the Foley irrigations I've done were with an antibiotic solution; however, when we need to unclog one quickly at my hospital, we use sterile water.
I've never thought about it before---this is a good question, BTW---but it seems to me that NS could be irritating to the delicate tissues inside the urethra and bladder, especially if there's already some trauma due to the insertion and presence of the catheter. Also.......whatever solution is used should be warmed to body temperature, as cold solution can cause spasms that are VERY uncomfortable for the patient (to say the least).
We do a lot of irrigations after the CBI has been discontinued following TURPs. The warming of fluid is a good point...of course what we use is room temp but 72 degrees is a great deal colder that 98 and could definately increase the spasms that the patient is already receiving, wonder if we could just wrap the CBI bag in a blanket and toss it in the blanket warmer? Of course then you run into getting it too hot and burning them up....just thinking out loud here..will try to pick the urologists brain next time he's on the floor
Our CBI (continuous bladder irrigation) is normal saline. It's wierd, but I can't remember what I've used to hand irrigate a foley, but I'm pretty sure the orders have been for normal saline.
As far as warming the saline used for an irrigant, I'd never heard of that before reading it here. Our bottles are at room temperature (I know-- cooler than body temp.) and when a patient needs to be irrigated and is having bladder spasms from passing a clot, I'm not thinking of warming the solution. I'm just moving as fast as humanly possible to irrigate the catheter and bring relief to the patient.
We DO have heating pads for warming peritoneal dialysis solutions which I guess could be draped over normal saline bottles.
We use normal saline at the bedside for hand irrigation to remove clots following CBIs. We dont warm fluids though. Havent ever had anyone complain of bladder spasm because of it although it may be an issue with some patients.
I'd been taught to use sterile water as the normal saline can irritate.....but with the CBI its never that big a problem. The hospital where I work keeps both normal saline and sterile water bottles of varying sizes in the blanket warmer......and patients do appreciate it.
i work on a urology floor and we use nss for CBI and also for irrigation.....never thought of warming it....dunno if it would be a good idea would think it could possibly burn....hard to tell the right temp i guess...love urology tho!!!
NS would be best I would think as it is isotonic, same as body's salinity.
Here's a "stupid" question.... when we're supposed to irrigate a regular indwelling foley (not a 3 lumen after a turp), does everybody just disconnect the foley from the tubing for the collecting bag? I always feel there's such a high chance of bacteria entering. But only other option is that small port we can draw urine from if we need a specimen.
I wouldn't mess with warming fluid, could cause a burn. fyi, though, I used to do peritoneal dialysis on a pt and we always had a warming pad going at bedside with bags on it for the next round.