Foley problem (gross hematuria)

Specialties Urology

Published

Hi everyone, I got one problem about my patient foley insertion.
(and wish to have your experience shared ><)

Below comes the background information:
He is GPH, young-middle age, started acute confusion, poor oral intake and noted no urine output x5 hours. Tachy + SOB + Cool limbs.
Bladder scanned ~400ml, so doctor ordered CSU+ Foley to BSB

I have chosen 16 fr foley, nil resistance, able to inflate ballon and secured. Still no flow at very beginning. Suddenly, gross blood (~25ml) passed out. 

At that time I worried about shock so I did clamp the foley then pull it out. 

Later, uro doctor used 22fr 3 way to insert successfully.

 

My question is, what should I do when gross blood passed out?
Should I pull out foley like this time (because in view of possible shock) or do bladder irrigation? or simply keep the foley inside (I worry the blood clot may form and then uneasy to pull it out)

Any comments?

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