Discussion

Epidurals and caths

Jun 30, 201214 yr

I'm having a disagreement with someone about this and wanted input from current L&D nurses. Is it standard procedure to have a foley with a laboring patient that has an epidural?

I worked in L&D for years (but haven't for the past 18years), and unless mom had been laboring for a long time and needed repeated straight caths, or was a likely c/s, we rarely put a foley in. We did straight cath some patients, but not the majority from what I recall.

I've had epidurals with 6 of my own kids, and was straight cathed twice, but also had pretty short labors.

So, what percentage of your epidural patients get straight cathed? How many of them get a foley?

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Jul 3, 201214 yr

This is the same policy where I work. They have 6 hours to void after the foley is removed, or they get straight caths. I think the reasoning behind straight caths is to decrease risk of bleeding, but not sure.

I uterus doesn't contract well with a full bladder.

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Jul 3, 201214 yr

Full bladders keep babies head from desending nicely too.

Personally? I Love foley's. One time in and done.

But I'm at a new job..so we'll see how they do it..

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Jul 5, 201214 yr

Unless the mom is going fast after the epidural, we do a foley. For those of you that do straight caths, what is the reason behind this policy? Isn't repeated in and out caths introduce more infection than a short term indwelling? Also seems more cost effective to do an indwelling since an in ad out can only be used once for sterility. I am always interested in doing Evidence based. We just don't see that many epidurals in the hospital based birth center that I work at, less than 20%

straight cath's are associated with lower CAUTIs I believe. The only patients that routinely get a foley are are section patients.

and I think its awesome that you have such a low epidural rate! How refreshing!

here is some good reading:

r.e. infection

http://www.ncbi.nlm.nih.gov/pubmed/22284373

http://onlinelibrary.wiley.com/doi/10.1046/j.1464-410X.1997.30018.x/abstract

http://www.ispub.com/journal/the-internet-journal-of-family-practice/volume-3-number-2/urinary-catheters-a-review.html

r.e. labor duration and post partum urinary retention

http://www.ncbi.nlm.nih.gov/pubmed/19100928

http://www.ncbi.nlm.nih.gov/pubmed/19100928.1

http://journals.lww.com/greenjournal/Citation/2005/09000/Postpartum_Urinary_Retention.25.aspx

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