Catheter Came out. Should I reinsert it?

[fergsu22]

I was working overnight in a retirement home and it was reported to me that a patient had pulled out their catheter. When I went to assess them I noted that they had no output in the catheter bag and their urethra was bleeding. I drained the balloon to help relieve pressure, but I didn't take the catheter out because I was scared of causing more damage. I wanted to reinsert a new catheter but I wasn't sure if I was going to cause harm to the patient, so I decided to send them to the hospital. Please help, I'm not sure if I made the right choice, I know it's better that I was overly cautious by sending them, but I never like to send people to the hospital unless it is absolutely necessary. I didn't feel comfortable reinserting it but I had to do something. Did I make the right choice?!

[Daisy4RN]

I know this is in Canada so things may be different, but I'm not understanding the amount of US nurses who think this is ok. Or who have never had a patient tug at their catheter and cause some blood. I would be in so much trouble and be side eyed for leaving a deflated catheter in the urethra.

I am not sure we know step by step what happened here. As far as leaving the deflated Cath in place, it is not common practice to do that. The only reason I can see is that the nurse could not easily pull it out and so just left it there for fear of causing damage cuz she didn't know what to do.

[psu_213, BSN, RN]

How does a doc assess for urethral damage?

About the only thing I have seen done is check a UA. And the urine for the UA is obtained by putting a new Foley in. If there was obvious bleeding from the urethra, then I can see why further eval by a urologist may be necessary before putting a new cath in. Otherwise, barring other extenuating circumstances, the ED nurse reinserts it.

[Crystal-Wings, LVN]

It sounds like you did the right thing. I've never worked in LTC or had a patient with an indwelling foley, but if I did and that situation happened to me and I had no one to ask, I would definitely send them out to the ER.

[Kooky Korky, BSN, RN]

So, OP, where are you, what's going on?

[remotefuse]

Reinserting the catheter with possible trauma would have been a bad idea, and depending on how bad the trauma was, he may need to do continuous bladder irrigation until the bleeding stops. You made the right call OP.