Foleys and tampons?

[JemJ]

Has anyone ever had a doctor order a patient to have a tampon in while having a foley? I've never thought that was a good idea . . . please don't start with the "well, it's two different holes!" (heard that one all day). I know that. But everyone always says how uncomfortable foleys are, and I speculate that having another tube shaped object in that area at the same time would not be fun . . . have a pt that's burned perianally and has a peroid so heavy that they cancelled surgery. Please advise/give opinions . . .

Thank you!

[bagladyrn, RN]

Another fact - from an OB nurse here - I've noticed that whenever I have a post c/section patient with a foley the blood runs down the foley (sort of wicks it away) and beyond the edge of the peripad, making more of a mess.

Thinking with a perianal burn that blood and/or the frequent cleaning needed would make more irritation, stay moist and probably provide more of a breeding ground for bacteria.

[PostOpPrincess, BSN, RN]

I do not put tampons in other women. That's potentially adding to a precarious situation already. That's why peripads were made. A tampon is for comfort only and sorry, but Toxic Shock is too close for comfort when a patient is sick.

I'm not doing it.

[merlee]

Toxic shock was nearly always due to a material that is no longer used in tampons, and to leaving them in too long.

We think nothing of placing foley caths, and doing peri-care. Inserting a tampon is no different from inserting lady partsl meds with an applicator. If the pt can't do it herself, we should have no problem doing it for her.

I would rather place a tampon in a woman, than do anal manipulation for a bowel program on a para or a quad. And I have done those.

This has nothing to do with OUR personal preferences, but what is good pt. care.

And her period is only a short time, anyway.

[leslie :-D]

I do not put tampons in other women. That's potentially adding to a precarious situation already. That's why peripads were made. A tampon is for comfort only and sorry, but Toxic Shock is too close for comfort when a patient is sick.

I'm not doing it.

and this is precisely why i think tampons are forbidden in many hospitals...

that the pt is usually too sick to change it, and the hosp will not risk relying on nurses to do it.

that's where the high risk for infection/tss sets in.

from a liability perspective, it makes sense to me.

leslie

[KeechieSan]

Side note: How does one get a perianal burn?? I am trying to think of a senario and I just can't.

[Altra, BSN, RN]

Rather than have menstrual flow in constant contact with burned peri tissue -- and the pain and increased infection risk that poses -- I'm all for a tampon in this case. In fact, I am quite sure I would have requested it if I were the patient.

There is no reason a tampon should increase the discomfort of Foley insertion.

[kesr]

OP - please let us know how this turns out.

[AnnaSL, BSN, RN]

Prolonged period of having catheter increase risk of having Infection, obviously for a reason that it is a foreign body. Plus the French of the Catheter is smaller and i doubt it that it will cause pain unless it was pulled or tugged

I have had post spinal surgery patients that have menses and at the same time catheter.

We've used a maternity pad for her due to her heavy menses and it's hard on her part because she had asked several times to change the pad and there would be instances while taking the pad out the catheter will also be tug or pulled.

Having known that it has a balloon inside anchoring the catheter inside, during that instance of immediate pulling patient complained pain.

For me, I think tampons is an advantage somehow, but depending on the patient's preference.

[PostOpPrincess, BSN, RN]

and this is precisely why i think tampons are forbidden in many hospitals...

that the pt is usually too sick to change it, and the hosp will not risk relying on nurses to do it.

that's where the high risk for infection/tss sets in.

from a liability perspective, it makes sense to me.

leslie

EXACTLY. That's what peripads are for. What happens when we get so busy or caught up in an emergency and heaven forbid we are not able to change the tampon? Give me a break.

That's all about convenience. If the patient can't do it herself, it isn't going to be done. I will tell her so. Should she like her husband, mom, whomever to help her. I'll get the stuff. But don't depend on me. In my 18 years of nursing, and I've seen blood galore. I haven't changed ONE tampon, and never intend to--and I don't care if it's super-duper-uber absorbent and can last for 25 hours, and promises to be infection free. Yeah, right. In a compromised patient. What's the priority here? Infection or comfort? I see the lawyer looking over my shoulder and he's saying, "INFECTION."

J

Edit to add: That foley needs to come out STAT just for the infection control issue of it all. Yes, it is SUPER INCONVENIENT to put her on a bedpan, but here again, convenience is IRRELEVANT. I don't want anyone to accuse me of ever becoming an accomplice to a vector. NO THANKS.

[bagladyrn, RN]

Why do you view the tampon as being any different than a lady partsl packing in a postop TVH? They generally come back with a foley as well.

[kids]

Edit to add: That foley needs to come out STAT just for the infection control issue of it all. Yes, it is SUPER INCONVENIENT to put her on a bedpan, but here again, convenience is IRRELEVANT. I don't want anyone to accuse me of ever becoming an accomplice to a vector. NO THANKS.

The patient has a foley as part of the treatment for peri-area burns, I don't think it has much to do with convience.

have a pt that's burned perianally and has a peroid so heavy that they cancelled surgery. Please advise/give opinions . . .

Thank you!

I can see where the use of a tampon could be appropriate in some unique situations, this being one of them.

[lovingtheunloved, ASN, RN]

I would think it would decrease the risk of infection. Sounds better than having loads of menstrual fluid at the meatus.