Epidurals & Foleys

Specialties Ob/Gyn

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Just curious about what nurses do for pt's with epidurals. Do you give them foleys or straight cath them? One place I was everyone with an epidural got a foley and this new place they straight cath. What is best practice?

Specializes in OB - L&D, M/B & Nursery.

Where I work it is strictly the physician's preference as to whether we put in a foley or not. Most order foleys although research has shown that even multiple straight caths have a lower rate of infection than one foley. We also put the patients on bed pans, pour in a little pepperment oil and it is amazing that most of them will void without even knowing it! :p`

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Where I work it is strictly the physician's preference as to whether we put in a foley or not. Most order foleys although research has shown that even multiple straight caths have a lower rate of infection than one foley. We also put the patients on bed pans, pour in a little pepperment oil and it is amazing that most of them will void without even knowing it! :p`

Wow, what's with the pepppermint oil?

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Specializes in Community, OB, Nursery.

Glad to see someone else using peppermint oil. LOVE IT for pp mamas who can't pee.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

We use peppermint or wintergreen oil to induce voiding. It does indeed work like a charm.

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Specializes in labor and delivery.

If you have to keep straight cathing every couple of hours you'll given your patient a UTI. Foley is best-it keeps the bladder from distending which may cause the baby not to decend and it keeps from continually having dragging bacteria from the outside to the inside. You may think a UTI is nothing but we just this past year had a lady die from urosepsis.

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Specializes in OB - L&D, M/B & Nursery.

When we DO use a foley it has to be a written order from the physician and we have to put it in our order entry computer as foley placed and what time, when it is removed it has to be put in with the date and time removed. If you go to the research engine "Up to date" it will give you the latest research on foleys and straight caths, which are sometimes called "in and out". Also the Cochrane reports will give you excellent research on the matter. All of the research shows that straight cathing, if done properly, even multiple times, is safer than indwelling catheters. You have to be really careful when straight cathing. The research shows that you should clean the entire lady partsl area with Betasept or something like that prior to straight cathing. Of course you also use the betadine around the urethra. Do the research, it's very enlightening. Getting the doctors on board is next to impossible, though, so we still insert foleys when ordered.

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Nether actually. If a pt has an epidural we get them up to the BR to void. Most of the time they are able to void on their own and only if they can't, do we cath them (which drastically cuts down the rate of UTI's). We assess them for bladder distention and measure voids but really we try not to interfere. If mom can't get up or can't void we assess the situation ( prime, multip, stage of labour ect) and will either do a foley or straight cath depending on a lot of factors.

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Nether actually. If a pt has an epidural we get them up to the BR to void. Most of the time they are able to void on their own and only if they can't, do we cath them (which drastically cuts down the rate of UTI's). We assess them for bladder distention and measure voids but really we try not to interfere. If mom can't get up or can't void we assess the situation ( prime, multip, stage of labour ect) and will either do a foley or straight cath depending on a lot of factors.

Ours couldn't get up if they tried or they'd be sitting on the floor their epidurals are so heavy...some can't get up for a couple of hours after delivery when you check a fundus after delivery you can just push out urine and they can't even tell or start to control it.

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Wow, what concentration do you use??????

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It depends on who is doing it and what the initial does is but most everybody goes on a ropivicaine drip at 8-14 usually it's 12 ml/hr which gets turned of at delivery. We used to use a bolus injection but don't often do that anymore. The hospitals I've worked perdiem at do the same thing.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Our epidurals and similar. They can't walk for a bit after them...and can't feel to pee, hence the need for a foley. Some are heavier than others-------all the docs use their own "Cocktail"....generally drip rates are about 10-12 ml/hr with PCEA option for the patient.

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Specializes in L&D.
Our epidurals and similar. They can't walk for a bit after them...and can't feel to pee, hence the need for a foley. Some are heavier than others-------all the docs use their own "Cocktail"....generally drip rates are about 10-12 ml/hr with PCEA option for the patient.

same here. I didn't realize there were people that COULD walk with an epidural running??

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