Foley caths and surgery

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I know I will regret asking such a silly and probably very elementary question of you seasoned OR nurses but its something that popped into my head one night, not sure why it did, but now its driving me crazy.

Are all patients foley cathed for ALL surgeries or are there set protocol for one or do certain docs want caths for some patients and not others? Is it dependant on where the surgery site is or how long the surgery will be gong on? For example, if you are having say, surgery on your ear that should last only 1 hour, are you cathed? Or does the surgery site/procedure and time frame not matter?

I've had over 15 surgeries in my lifetime. Most were GYN related so I assume a foley was placed. But I have had some laproscopic surgeries and some non-gyn surgeries and now I wonder, was I cathed for that too? Its not a big deal, I just was curious.

I appreciate anyone's input. :)

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Specializes in O.R., ED, M/S.

Not always. We don't insert folys in Lap Chole patients and usually the majority of surgical procedures. Why? Surgeons believe this might be an avenue of infection and don't want one unless necessary. Almost all bowel cases get one though.

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Your answer is exactly what I was thinking. Foleys are usually only placed when absolutely needed, no need to possibly introduce bacteria into the body.

Thanks so much.

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The shorter the case, the less likely they will need a foley.

Some GYN surgeons will want you to straight cath before laparoscopic cases, but if you ask the patient to pee right before the case, that will be good enough, which is what I do. Straight cath could always lead to a UTI.

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Specializes in US Army.

Short case, no cath, but if the surgery is estimated to exceed 3 hours we like place a Foley.

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We do for cases expected to be close to 4 hrs or over. Also on certain procedures we do an in/out to reduce the size of the bladder. We do not do Foley as a routine because of the possibility of UTI.

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Specializes in O.R., pediatrics, gynecology, surgical.

In gyne cases,, esp, ceasarian section, which lasts usually 30 minutes only. We put foley catheter due to a very important reason.We need to see if the urine coming our is free of blood before and after the surgery to be sure the surgeon did not hit the bladder since the bladder is located just below the uterus...

In cases that is expected to lasts for hours, we do folley catheter like neuro cases(laminectomy, spinal fixation)..

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Specializes in Operating Room.

It depends on the duration of surgery, for the most part. If a patient is undergoing a 120 minute or less surgery, a foley may not be ordered. We just try to have the patient empty their bladder before being given the pre-op meds.

If they didn't, then it's up to the surgeon and/or anesthesia as to whether or not we place a foley.

We usually will insert a foley in cases of 180 min or longer duration, especially in female patients. (Maybe because it is easier for a male to use a urinal than a female to use a bedpan???? Dont' know on that one!)

A foley is definitely not the norm now days!

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Specializes in Operating Room (and a bit of med/surg).

We cath almost all patients who have a surgery booked for 2.5h or more, and some booked for 2h. Also depends on the procedure- like someone else mentioned- for hysts and stuff we usually do due to the fact that the bladder is so closely involved.

It's not always ordered though so we usually end up checking with the doc before inserting. No sense putting one in if they don't really want it!

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