Do you pre-inflate the balloon on a foley cath?

[VegGal]

I work in LTC and some nurses still pre-inflate the balloons on foley caths, while others don't. And now I'm confused and unsure which method to follow. Didn't nursing research find that pre-inflating foley cath balloons caused more damage than good? Which method do most nurses use? I was in RN school just a couple years ago and we were still pre-inflating back then, but since graduating I've come across conflicting info and am unsure which to follow.

Thank you.

[nursej22, MSN, RN]

In thirty years I have never seen a defective catheter balloon.

[NuGuyNurse2b]

Could you explain your reasoning of why that might be easier to do if you pre-inflate?

Because in that specific case, maybe she didn't deflate the balloon completely so when she did inflate it in the urethra it didn't give much more resistance, leading her to think it's in the bladder.

[Meeshie]

We talked about this in school after an fun lab incident. We had pre-inflated per our school protocol and then on the second inflation the balloon exploded. Apparently that happens sometimes. Because the manufacturers say not to do it now... if you do re-inflate and something happens you've not followed the basic directions for the product. It makes lawsuits easy.

[NurseSpeedy, ADN, LPN, RN]

Because in that specific case, maybe she didn't deflate the balloon completely so when she did inflate it in the urethra it didn't give much more resistance, leading her to think it's in the bladder.

Actually, it wouldn't have anything to do with preinflating the balloon. When inserting a male catheter it is best to insert the catheter all the way in and then inflate the balloon. In some issues concerning the prostate in male patients, there can actually be some urine in the prostate causing urine to appear in the tubing, while it is not yet in the bladder (part of a hospital inservice).

[Ruby Vee, BSN]

Could you explain your reasoning of why that might be easier to do if you pre-inflate?

Without having any scientific evidence, I'll take a stab at this one.

When you inflate the balloon the very first time, it takes just a titch more force to inflate it. Subsequent inflations are easier because the balloon has already been forced open once and the insides are no longer adhering to one another.

After inflating the balloon the first time, it never goes completely back to the sleek, compact form it has when you first lift it out of the package.

[Ruby Vee, BSN]

Hospital inservice recently where I work emphasized NOT inflating the balloon prior. Rationale was 1) each is checked by manufacturer prior 2) it increases risk for urethral trauma on insertion and 3) this trauma can increase risk for infection.

Over the years, I've seen a huge reduction in the use of catheters all together.

And over the years I've seen a huge reduction in quality. Our hospital had a whole batch of catheters where balloons were defective and many of them (not all or even most, but quite a few) failed.

[hawaiicarl, BSN, RN]

EBP, and the manufacturer both say not to pre-inflate balloons. This is one of those old practices that never seem to go away no matter how much education on the rationale is done.

Carl

[Eeramsey, BSN, RN]

I am currently in school. At first we were taught TO INFLATE, now, we are taught NOT to.

[sjalv]

I was taught to not inflate and I never do. I also do not know any nurses that do.

[VegGal, BSN, RN]

What does your facility's procedure say about inflating Foley balloons? Does it say to inflate them? If you have evidence that it's a poor practice, perhaps you can get your procedure updated. You'll need to find research to back you up before you attempt to change the procedure however.

Unfortunately, my facility doesn't seem to have a procedure. I've asked the senior RNs and the DON and they say that it's the way to do it (to pre-inflate). I feel that it's not something detrimental to the patient, so I'm OK with continuing to pre-inflate, but I'd like to use EBP and go with what's right based on research, and that's why I've asked the question here just to get some opinions.

[VegGal, BSN, RN]

I was taught to pre-inflate back when i learned. I am aware that this is no longer standard practice. I see nurses do it both ways. I very much doubt it makes any significant difference either way and have not seen any convincing data indicating substantialy better or worse outcomes from one practice vs another. If said data, exists, id be happy to see it. Till then... meh. Follow facility policy i guess.

That's how I'm beginning to see it too. No negative consequences to patient due to pre-inflating, so I'll probably continue to do that at this facility as they have no concrete protocol either way, and when asked they said that it's the accepted practice (to pre-inflate).

[VegGal, BSN, RN]

Hospital inservice recently where I work emphasized NOT inflating the balloon prior. Rationale was 1) each is checked by manufacturer prior 2) it increases risk for urethral trauma on insertion and 3) this trauma can increase risk for infection.

Over the years, I've seen a huge reduction in the use of catheters all together.

Thank you for all that info. I will look it up further and present it to my Manager.