Foley balloon, test or not to test

GooeyRN, ADN, BSN, CNA, LPN, RN · May 29, 2006

I test it.

TracyB,RN, RN · Jun 9, 2006

I test at work, don't at home. Caring for hubby's gram, who has had a foley for years. When I originally starting doing her cath changes (after multiple changes by home health nurse resulted in UTI after UTI) & tested balloon prior to insertion, it would never fail that the cath would leak after about a week. When I stopped testing after reading some article about it, the leaking issue ceased. We do use a silicone cath d/t latex allergies for gram, so I don't know if the silicone has anything to do with it. That balloon is much more difficult to inflate & the cath itself is pretty stiff.

Marijke · Jun 17, 2006

As far as I know it, testing the balloon is a sacred cow, which should be discontinued. Especially in the larger catheter sizes, testing the balloon makes the outside of the catheter less smooth, this can cause irritation of the urethra, which makes the patient more prone to an infection.

I have this from several reputable sources (including several urologists and one of the major manufacturers in the world).

A balloon which does not stay inflated rarely can cause harm to the patient, just some inconvenience having to reinsert. Bladder infections on the other hand can cause very serious problems in hospitalized patients. Everything we can do to prevent these infections should be done (and this one is easy).

I know I will probably get some arguments against my stand, but I am totally comfortable with my decission not to test the balloon of an urinary catheter.

I do test the balloon on an ET tube, since a defective balloon on that one could cause the patient to aspirate (and we all know what happens after that).

Marijke:sofahider

scrubnurse · Sep 22, 2006

I always test the balloon.

I have also had a balloon that would not deflate. Luckily, I had tested it, so it was never put in the bladder. We threw it out and got a new one.

What if I hadn't tested it, we used it and it didn't deflate? :nono:

It only takes a few seconds to check.

Arkansas RN · Sep 22, 2006

I agree with all the above and always test the balloon. I too have had many defective balloons over the years. I also leave the syringe attached to make it easier to inflate after without taking my insertion hand off the catheter to be sure it stays in....especially if the pt is fighting you.

shodobe · Sep 22, 2006

Been testing for 30 years and will not discontinue beause of some urologist or manufacturer saying it is not necessary. My ease of mind is all I need. I have had a few failures over the years and it only takes one to get into a very good habit. When a balloon won't deflate and you have to take a patient to the OR for a simple foley removal is quite simply unacceptable. All of this could be avoided with a simple test. In all of my years not one urologist or reputable sales rep from a well known urology company, Bard, Boston Scientific, etc... has ever said "Don't do it"! In fact all have said the opposite, please test because I don't want to get a call at 3am about a foley malfunction. As I said, it only takes a few seconds to put your mind at ease andI don't mind being considered a "cow" for this. Alot of bogus excuses for not doing something that is the right thing to do..

RN Zeke · Sep 23, 2006

Test, test test

I know this question has probably been run through the mill before, but I would like to post it once again.
There is a debate starting to gather steam at my hospital on testing the balloon on a foley before inserting it.
I'm a bit old school, and for the record, I DO test inflate the balloon. :chair:
I go as far as pulling off the syringe with the balloon up, usually not all the way, squeeze the balloon a tad, then re-attach the syringe bringing the balloon back down.
The opposition says blowing up the balloon stresses it needlessly, and could cause premature failure.
I've seen failures of all sorts with foley's in my 30 plus years in the biz, and unless someone can convince me with rock solid evidence....I'm not going to change my mind now!!
Kind of a medical Shakespere question: "To test the foley, or not to test,,that is the question". :chuckle
Mike

tessa_RN · Sep 23, 2006

I always test the ballon..I have had a foley where the ballon was messed up when I tested it..I think its a good thing...I never as someone else said inflate it until I get urine..

ortess1971 · Sep 30, 2006

I always test, was taught to test the balloon. Also, sorry for hijacking the thread, but what about the little forceps in the kit? I was taught by my preceptor to always use then when prepping the urethra-I have seen quite a few nurses where I work not using them. It seems to me that you prep with your "clean" hand so shouldn't they be used? If you just swipe with the cotton ball, possibly you could touch the genital area by mistake, and contaminate the whole process...?

txspadequeenRN, BSN, RN · Sep 30, 2006

I have always tested and will continue to test . But how in the world will you ever find out if there is a problem with a balloon if you do not test.

txspadequeenRN, BSN, RN · Sep 30, 2006

Having a foley in your urethra is a irritant itself and makes you more prone to having UTI's. If you dont check your balloon before you insert and you have a balloon that will not stay filled , you say it is just a inconveniece and you then must reinsert. You are raising the risk of infection when you insert things in fragile areas over and over and not to mention that the patient must suffer through another insertion...if you have never had one they are not pleasent. You are right UTI's are real trouble for hospitalized patients so we should be doing everything possible to minimize the risk for infection. Doing something a little as checking the balloon prior to entry to ensure patency will minimize having to re-insert. Then there is another whole issue as well...What do you do when the balloon (foley already inserted) does not deflate properly? Alot of these defects are caught upon checking the balloon prior to insertion. just my opinions.....

As far as I know it, testing the balloon is a sacred cow, which should be discontinued. Especially in the larger catheter sizes, testing the balloon makes the outside of the catheter less smooth, this can cause irritation of the urethra, which makes the patient more prone to an infection.
I have this from several reputable sources (including several urologists and one of the major manufacturers in the world).
A balloon which does not stay inflated rarely can cause harm to the patient, just some inconvenience having to reinsert. Bladder infections on the other hand can cause very serious problems in hospitalized patients. Everything we can do to prevent these infections should be done (and this one is easy).
I know I will probably get some arguments against my stand, but I am totally comfortable with my decission not to test the balloon of an urinary catheter.
I do test the balloon on an ET tube, since a defective balloon on that one could cause the patient to aspirate (and we all know what happens after that).
Marijke:sofahider

Marie_LPN, RN, LPN, RN · Sep 30, 2006

It seems to me that you prep with your "clean" hand so shouldn't they be used? If you just swipe with the cotton ball, possibly you could touch the genital area by mistake, and contaminate the whole process...?

Those 'cotton ball' forceps should be used. If someone were not to use them on, say, a woman with long pubic hair, odds are very good they'll contaminate the "clean" hand.