balloon testing prior to insertion of foley

bigg_redd · Sep 4, 2009

Thanks for the reply MORKO. I kinda felt like I was being treated like a criminal today as my testing instructor scolded me for not inflating. After a couple of phone calls, the rule has been changed again. Now we have to inflate. The bad thing is I was asked to sign a paper (that goes in my file) saying that I had to retest because I needed further instruction. So not fair!!! Well I decided to make my own rule, I am going to test the balloon (for precautionary measures) no matter what anyone says. :nono: It all comes down to if I decide to perform such an invasive proceedure without knowing whether or not my equipment works and consequently have to start all over, then my care was not patient focused. I WILL BE TESTING FROM NOW ON!!! :saint:

groovy jeff, RN · Sep 5, 2009

I did an EBSCO search and could not find anything relating to a study; I must be board, huh.............

dishes, BSN, RN · Sep 28, 2009

I no longer pre-test the catheter, haven't for more then a decade and have never seen a urologist do this. There isn't solid evidence to support pre-testing, just a handful of defective balloons, so I am not going to go back to this "habit" of pre-testing. There is some literature available on this topic, see link below for article Indwelling catheter management from habit-based to evidence-based practice

Pretesting catheter balloons is commonly recommended as a way to prevent insertion of a defective catheter. Some catheter manufacturers no longer recommend pretesting because their balloons are pretested during the manufacturing process. Pretesting silicone balloons is not recommended; the silicone can form a cuff or crease at the balloon area that can cause trauma to the urethra during catheter insertion.10,13

http://www.o-wm.com/content/indwelling-catheter-management-from-habit-based-evidence-based-practice

dishes

gettingupthere · Oct 4, 2009

I have been inserting foleys for 40 yrs! I have never pre-tested a foley bulb! Never was taught this practice in school! BUT, yesterday I was placing a foley in a pt with a new graduate assisting me. She asked me if I was going to pre-test the bulb? I looked at her, and told her "no, I've never heard of that" She too tells me it's a practice being taught. I have NEVER had a problem ( and hope I never do". When did this come into practice? Have I been living under a rock?

AirforceRN, RN · Oct 4, 2009

Just to throw a little mix into the pot...

I was taught to test the catheter, not to ensure the balloon is intact (who cares if the balloon fails? Its just pee) but to ensure that the valve allowing the balloon to deflate is functional. I guess there have been cases where the balloon can not be deflated making for bad removals.

gettingupthere · Oct 4, 2009

Just to throw a little mix into the pot...
I was taught to test the catheter, not to ensure the balloon is intact (who cares if the balloon fails? Its just pee) but to ensure that the valve allowing the balloon to deflate is functional. I guess there have been cases where the balloon can not be deflated making for bad removals.

Ahhh, now THAT DID happen to me many years ago! The cath wouln't deflate, my supervisor said to "cut the cath and pull it out" Guess what? I wouldn't come out!!!! Had to send her to a urologist! Bad thing to do! Never did that again!

dishes, BSN, RN · Oct 4, 2009

I have heard both the faulty balloon and/or faulty valve reasons given for pre-testing the ballon, but pre testing doesn't guarantee the valve or balloon won't be defective after the catheter is in the bladder. Both problems of leaking balloon or defective valve are rare and resolvable. There isn't evidence to support pre-testing and nursing schools should stop teaching it, or at least give evidence based research to support teaching it.

dishes

dishes, BSN, RN · Oct 4, 2009

Ahhh, now THAT DID happen to me many years ago! The cath wouln't deflate, my supervisor said to "cut the cath and pull it out" Guess what? I wouldn't come out!!!! Had to send her to a urologist! Bad thing to do! Never did that again!

Yes if it won't deflate, get in touch with the urologist.

dishes

tewdles, RN · Oct 6, 2009

I was taught to pretest the cath before insertion. I haven't actually performed that test for probably 25 years because I felt that doing so altered the smoothness of the catheter and increased patient discomfort during insertion. I have to date never had a baloon failure after insertion. In hospice I frequently remove the catheter by cutting it rather than rustling around for a syringe...works like a charm.

MidniteLaborRN · Feb 3, 2010

I was told just last week in orientation that Bard will only guarantee one inflation. So after may years of pretesting, I will not again.

jnrsmommy · Feb 3, 2010

Had a urologist that I used to work with, he was very adamant about not pre-testing the balloons. Said that they don't fully collapse back, further increasing the risk for injury/trauma when inserting.

OncallRN · Feb 5, 2010

Just to throw a little mix into the pot...
I was taught to test the catheter, not to ensure the balloon is intact (who cares if the balloon fails? Its just pee) but to ensure that the valve allowing the balloon to deflate is functional. I guess there have been cases where the balloon can not be deflated making for bad removals.

if you can't remove the fuild in the ballon just cut the catheter... sure has heck DON"T just pull it out if you can't remove the fuild.

Working in Home care/ hospice finding a syrigne to remove the fuild can be imposible but you can always deflate the balloon by cutting the catheter. you can just cut off the fill port while covering the port with a chuck and the balloon is empty.