Foley Position

witzend · Sep 8, 2003

under the leg - even in 2003 urine wont flow uphill ...

kathyann · Sep 8, 2003

We also always put the foley under the leg.....again, adds stability for the cath. unde the drape, and prevents inadvertantly pulling it when removing the drapes.I have not ever seen a patient with a resultant skin problem after surgery when done properly.

Rapheal · Sep 9, 2003

Under the leg with checks for patency. Here's why I like it this way:

A little more difficult for confused, unrestrained patients to pull out.

A little more difficult for staff and family members to accidently pull on when fixing, moving patient blankets.

When a patient has scooched all the way to one side of the bed and the foley has reached it's lenght and there is no more room- this position helps prevent it from being pulled out when they raise their leg or knee.

I have also seen more skin damage by foley tubes positioned over the leg because I have seen them get caught in the skin at the folds of the thigh were they leave welts-have not seen any skin damage from under the leg (yet).

Circl8r · Sep 16, 2003

Witzend...you said it so succintly :)

Donna

huckfinn · Sep 18, 2003

We put it under the leg. Over the leg would cause tension on the sphincter or alternately a dependent loop if there is not enough tension.

Lisa K. · Sep 20, 2003

I have been taught to place the foley tube under the leg at the bend of the knee with sufficient slack on the tubing and checking for pressure and patency while in the supine position. For all of our MD's at our facility, this is the preferred method.

wildwood · Sep 20, 2003

We position the foley underneath the leg during surgery to facilitate drainage and to keep it out of the surgical field. It is positioned normally after the procedure.

carcha · Sep 24, 2003

we too put the tube to the end of the table which means its between the patient's legs. That makes it easier to measure the urine too as we just peep under the end drape to see. However I can see the point of pressure sores. I think this one should rely on evidence rather then tradition .

Chrislynn2003 · Oct 1, 2003

Was just taught under the leg.

stevierae · Oct 10, 2003

Under the leg at the knee is how I do it, just like everone else. It makes sense that the urine would flow better, due to the flow of gravity, but I don't know that anyone has ever done a study to see if it actually makes a difference. I have seen nursing journal articles where they recommend OVER the leg--even taping it ON TOP the thigh--but you would get weird looks in the OR if you did that.

I do know that some people are afraid that if you leave the Foley at bed level it will reflux--but this is no longer true--all Foleys have anti-reflux valves these days, and have for many years--but in nursing school, we were always chastised for doing this, and sometimes still are today.

LilRedRN1973 · Oct 10, 2003

Oh gosh...now I'm really confused....we just did catheters in lab and were told to make sure it's OVER the leg. UGH...how come we are taught something in school and then it ends up being different out in the real world?????

yoga crna · Oct 13, 2003

Take it easy on the CRNA. He has a lot more responsibility/liablity for complications than you do. If you don't believe me, I will be happy to refer you to a recent Kansas case where a patient received a burn from a betadine prep that got under the orthopedic tourniquet. The CRNA didn't prep the patient, but was held liable.

After 43 years of administering anesthesia, I don't think it makes any difference when the catheter tubing is placed, as long as it is draining well, is not kinked, is not pulling on the meatus, and is not pressing on anything. I change the location of the tubing every several hours on long cases. I have never seen a problem, nor have I found one in the medical literature.

By the way, if you want to be treated and paid like a professional, you need to act like one. I learned a long time ago that one should not speak poorly of a colleague. The crude remarks about the CRNA were unnecessary to the topic at hand and just maybe he knows more about physiology than you do.

YogaCRNA