Foley Balloon Test

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In school we were taught to pre-inflate the balloon on the Foley to make sure there weren't any pin holes. In reality, the urologists don't want you to pre-inflate because they say it makes the ribs on the balloon stick out which could cause irritation to the urethra when you do insert the Foley. I've put in hundreds of Foley catheters on my patients and never had any problems until yesterday when one of the general surgeons was watching me and had a huge pissy fit because I didn't pre-inflate the balloon ? I responded that the urologists say otherwise and he wasn't impressed with my answer.

Just wondering how many of you out there either inflate or don't when putting in the Foley. I've never had a balloon not work in my hundreds of times of putting one in and figure that if there is a hole, you'll find out when you pull back on the catheter and it comes back out because it's not inflated. I feel it's pretty much a non-issue but now they are making a big deal out of this where I work.

Here's my experience, and my opinion based on it. After all, that's really all any of us have to go by, isn't it?

I was taught to test the balloon, and no one (including urologists I worked with several years ago) has ever told me not to, so I always test every balloon before inserting the Foley.

I did have a defective balloon once, one that would not fully deflate. I was really glad at the time that I had tested it and not inserted it into the patient.

I will continue to test the balloon, based on my personal experience, unless asked not to do so by a surgeon or instructed not to do so by hospital policy.

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I'm fresh out of school and just started in the OR in May. When I inserted my first foley in the OR I checked the balloon (as I was taught in school) and someone in the room corrected me. This person cited the reason as messing with the integrity of the balloon. Apparently this a fairly new policy in place at our facility. Still makes no sense to me...

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Specializes in ICU, PACU, OR.

I recieved a notice from the BARD company which recommends not to test balloons. The urologists apparently are correct. The balloon never goes back to the original size even if it is hard to detect. There are ribs on the balloon.

So, you might want to bring it to the attention of the clinical educator in your department and hospital wide. This seems to be something that US nurses may not have been told or have chosen to not adapt this new manufacturer's instructions. It will be a huge undertaking to get rid of a sacred cow.:uhoh3:

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Specializes in OR scrub/circulator, hospice crisis care.

I am new to the OR- still in periop training. I was taught in school to always inflate. In periop training, I was taught that latex caths are being phased out, and the new silicon catheters shouldn't be inflated, and it was easy to see the large amount of distortion when demonstrated. I mentioned this training to a preceptor, while I inserted a latex cath, and he said he would be interested to see ifthat becomes the policy... i.e, we won't do stop inflating until it's officially changed, which I understand perfectly.

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Specializes in ICU, PACU, OR.

That is true and we are now going latex free. Our catheters have all been changed over to silver impregnated caths for infection control as well. I am going to investigate further. Best rule though is to read and follow your manufacturers instructions no matter what the type. Policies tend to lag a little behind changes so your policies may need to be revised after some research. :wink2:

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Specializes in 2 years school nurse, 15 in the OR!.

How funny, I never even thought about this. I have always checked my balloon. Anyhow, today we were putting a foley in a total knee patient, and we were having difficulty. A urologist came in and told us we are not supposed to inflate the balloon. He said it irritates the urethra, (doesn't putting a foley in irritate the urethra???), and said it's a big waste of time. Interesting...I dunno, it's habit for me and it will take a lot to get it changed in our OR.

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Specializes in Emergency, outpatient.

Have you ever tried to suck the balloon fluid out when the deflation valve would not work? Not an easy task, and you can't just "cut the tail off." That is the MAIN reason I test the balloon. I want to know it will deflate. I've seen two in 22 years that would not deflate after insertion, and I had tested both prior to insertion. So we had to find the lumen with an 18ga needle to withdraw the fluid.

The "ribs on the balloon" theory I have trouble with. Aren't there two big honking holes in the end of the catheter? Don't said holes rub against the inner lining of the urethra during insertion? I would think these are much worse than any unfolded ribs.

I test the balloon. Always.

Carry on.....:D

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At the hospital I work at we are told to pre-inflate the foleys...however if it is a coude we are not supposed to...for the same reason as your urologists gave. It doesn't make much sense to me either...I don't know why we test some but not others...

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Specializes in Cardiac Telemetry, Emergency, SAFE.

At our facility, the hospital policy has just recently changed to NOT inflating the balloon d/t the ribs sticking out. (We've preinflated the foleys for YEARS!!!)

Upon telling this to a urologist, he had a fit! LOL. He always wants his foleys checked b/c we do find them with either faulty valves or holes in the balloons. Alot of the urologists also feel the same.

You just cant win. :uhoh3:

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Specializes in surgical, emergency.

If you look back in the allnurses archives, I think you'll find plenty of discussion on this topic.

Myself I always test balloons first. I've gone one step more by pulling off the syringe with the balloon up. Thay way, I test the balloon and the valve too.

I understand that sometimes the balloon doesn't deflate to the "original" state, but I've never heard of any problems.

I did have a balloon/valve falure, maybe once, that I've heard of, in the past 30 years.

Mike

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Specializes in OR.

we do not inflate the balloon also because we only use silicone latex free catheter and the urologist came with this policy

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Specializes in OR; Telemetry; PACU.

I was taught to pre-inflate...and I've never been told different in practice and I've never saw anyone not do it.

I just think you're always going to find a doctor who has his/her own way of doing things...and man, I tell ya it could be ONE study or ONE bad experience or a colleague's bad experience and that's it! They are doing it this way. Anesthesia seems to do this a lot.

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