Air to Bladder

ICURN3020 · Jan 19, 2015

Personally I have not heard of or witnessed air being used to unclog/improve patency of a bladder catheter. I have had patients who were on continuous bladder irrigations (with fluids) to prevent clots from forming and flush any that did form through to prevent blockage.

I am by no means an expert in urology. This may be a new technique I just wasn't aware of.

CTnewgrad826 · Jan 19, 2015

Even with CBI we still get pts needing intermittent manual irrigation and I've only used water to try and flush out the excess clots. I wouldn't think injecting a small amount of air would be a big deal but I haven't seen it done.

dudette10, MSN, RN · Jan 19, 2015

That sounds like an incorrect technique. With interns who are doing nursing procedures--and who look like they don't know what they are doing--I would just say, "Usuallywe flush with NS. I've never seen it done with air. Is that a new technique or do you want me to grab some NS for flushing?"

Approaching it that way allows them to save face, maintains good nurse-doc relationships, and, most importantly protects the patient.

calivianya, BSN, RN · Jan 19, 2015

I have never heard of that either. If you run into that resident again, could you ask his/her rationale? Say something like, "I noticed you flushed air into the bladder to remove a clot from a foley the other day. I was just hoping you could teach me a little more about the use of injecting air instead of water/saline since that was the first time I have seen a foley unclogged that way and I am always interested in learning new things."

Some of them are really sensitive to their toes being stepped on... but I would be curious in hearing the answer myself.

NewlyGradBSN · Jan 19, 2015

I know. I haven't seen it also. I'll ask him if I see him again. But is that harmful or dangerous to the patient? I think she was discharged yesterday. No complaints whatsoever. Immediately after the doctor flushed it, I saw urine with air in between come out towards the bag. It almost gave me a heart attack actually when I saw the resident go about it.

AgentBeast, MSN, RN · Jan 19, 2015

It's not harmful, but it's not effective either. Air is a gas and gasses compress. So if the catheter is clogged up good all the air is doing is compressing in the catheter. Fluids do not compress.

NewlyGradBSN · Jan 19, 2015

As long as it is not harmful, I can sleep good tonight.

wheeliesurfer · Jan 19, 2015

(Personal experience and not EBP expressed here)

I had a long term in dwelling catheter for over a year and would find that at times the foley would get "stuck" to the bladder wall and would be irritating/painful. I always kept a cath tipped syringe with me to flush if necessary, but barring a clean source of water sometimes I would "flush" a small amount of air (a few cc can make a HUGE difference!) to push the mucus or bladder wall off of the catheter. I would preferably use NS or sterile water for flushing, but if air is all you have atm I don't think a small amount will do any harm. It's not like the air can get into the bloodstream and cause an embolus or something. However, I also would not use a large amount of air for fear of increasing the bladder pressure and having air/urine back flow to the kidneys. I think in the clinical setting that fluids are the best option.

applewhitern, BSN, RN · Jan 20, 2015

I wonder about giving the patient an air embolus. I have read about getting one lady partslly but I don't know about getting one by pushing air into the bladder.

NewlyGradBSN · Jan 20, 2015

So I've been reading on this. It seems there are procedures like air cystoscopy and imaging studies that inject air into the bladder to visualize tumors. They even inject room air. The process is called air insufflation of the bladder. This was probably his basis right? I haven't seen him yet and his probably on vacation. Are you familiar with those procedures??