Continuous bladder irrigation

[Sue B]

What do you do if a CBI (continuous bladder irrigation) bag runs dry and there is air in the line?

[Been there,done that, ASN, RN]

Did the patient receive air into the bladder? I would prepare a new bag and line. Notify the ordering physician as to further orders.

[Sue B]

Caught it just in the nick of time, was wondering what to do if it ever actually happens.  Thanks for your reply ?

[MaxAttack, BSN, RN]

There's really not any risk. The bladder is insufflated during surgical procedures; it's not like we're concerned about air embolisms like with an IV.

I can't foresee a lot of air would enter anyways.

Without fluid, there's no pressure (besides however much height contributes) that would force air in the tubing forward and there's pressure in your abdomen/bladder that air would have to push against. 

I would just re-prime and keep on going. I'd be more concerned about clot formation inside the bladder depending on how long it was dry.

[nursejennie]

My unit is going to start having CBI patients and I have this same question. If your line runs dry before you can get to the patient's room in time, do you disconnect the line from the foley, re prime with the new bag and then restart? How often is CBI tubing changed? 

[mmc51264, BSN, MSN, RN]

nursejennie said:

do you disconnect the line from the foley, re prime with the new bag and then restart? How often is CBI tubing changed? 

You should have a policy or protocol that addresses all those issues. I would think you would have some education/in-service plus support when you start getting these pts. It actually is not that difficult. 🙂

[A. D.]

Hang the new bag first while line is clamped, clean the port that is closest to the patient and attach an Empty syringe, pinch the tubing so that nothing goes into the patient while releasing clamp and pulling the air out of the tube via syringe. You may need more than one syringe or simply detach syringe and push the air out of it it before cleaning the port and re-attaching. Once the tube is full of saline, you can release the line. Keep the flush attached in case you will need to push saline to unclog blood clots that may have formed while the bag was dry.  You're welcome.

[Annon16453799]

1. always have at least 1 back up in the room

2. ensure rate is appropriate, color is desired

3. decide which bag is your primary bag, when one gets low set the other bag at a slower rate so that you have more warning

4. don't forget so make sure the rate is adequate

5. don't forget to make sure drip chamber is half full

6. use patient and family as a resource. They don't care, they are afraid.

7. who cares if you throw a little normal saline in the trash

8. prepare to empty foley bag frequently

9. you got this

10. prevention, who?