Foleys and tampons?

Nurses General Nursing

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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!

Specializes in Med/Surg.

I'm surprised at how many people seem so appalled at this idea.

If the person has compromised perineal skin, then a tampon is a VERY reasonable way to minimize drainage that comes in to contact with that skin. Frequent peri care, if a pad is used, plus having to clean (and therefore manipulate) the foley while doing so, also increases infection risk. TSS is an EXTREMELY minimal risk now a days. Tampons can also be safely left in place for 8 hours (what is generally considered the length of time to be "overnight") as long as it doesn't leak in between, so the reasoning that "should the nurse 'forget' or 'not have time' to change it just isn't logical, either. All excuses.

It shouldn't and wouldn't cause discomfort either, to have both in place at the same time. Think of your anatomy and you'll come up with that answer. As someone said, also, tampons can help decrease the discomfort of cramps for whatever reason (they sure do for me; I have MUCH more pain from my cramps if I go without!) so it actually may result in INCREASED comfort for the patient, from that perspective, not to mention a less frequent need for peri care on already inflamed skin.

No, I wouldn't personally be COMFORTABLE being the one to change it (no one said the patient can't, though?), but we do a lot of things that aren't considered "comfortable." Pretty sure I'd rather change a tampon than do a bowel routine on a quad any day, now THAT I don't like doing!

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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.

You would rather this pt be placed on a bedpan so she can practically sit in her own urine as she is waiting for it to be removed from under her with burns in the peri area? Not my idea of infection control. :(

I'm also suprised at all of the people who have such strong opinions of changing a tampon. If I had a pt who questioned the use of a tampon, whose outcome would benefit from its use, I would have no problem assisting or performing the change on my own. Peripads would have to be changed as often as I can't imagine that the blood collecting on the pad would not be a high risk of infection to healing skin- it creates a wet, warm environment. My thought is that the use of tampons in this case would promote healing and comfort and decrease the risk of infection. Why can a nurse be responsible for titrating life saving meds, administrating meds at regular intervals etc, but not prioritize changing a tampon in a timely manner if the pt's condition benefits from its use?

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

It does sound like urine in contact with a burned perianal area when on a bedpan would hurt like the dickens, especially if the epidermal layer is damaged and there are erosions which could be made worse from the friction of washing. Then there's the reality that people aren't cleaned right away many times.

Well this thread has provided a lot of food for thought from everyone. Interesting.

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Specializes in Peds, PACU, ICU, ER, OB, MED-Surg,.

This was obviously ordered for several reasons. You lower the risk of infection by keeping the area clean. Patient more comfortable by not requiring frequent cleaning of a burned area. I'm shocked by people that are suppose to be in the caring field not realizing why this would be ordered? I would prefer changing a tampon to disimpacting a megacolon....

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

A tampon is for comfort.

But off topic, I'd like to know why the patient isn't ambulatory? I've done care on patients before with perineal surgeries and I & Ds, with packing and SEVERE pain. I can tell you now, that foley is MORE of a problem than not.

What's it for? Patient is unable to void? And if the menstrual period is THAT bad--why? Fibroids? Is an emergency D & C warranted?

From the situation from the OP, it's all about comfort. Besides that, what's wrong with her arms? She can't get up? I don't understand this scenario? Is she comatose?

Please explain.

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

Maybe she was trying to wax herself and it was way too hot.

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Specializes in LTC, home health, critical care, pulmonary nursing.
Maybe she was trying to wax herself and it was way too hot.

Um, ouch.

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A tampon is for comfort

Why is that a bad thing, to be avoided? Isn't morphine a comfort measure, too?

Please, original poster, come back and give us the rest of the storey.

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Specializes in Med/Surg.

Am I missing a post, from the OP, that says that the patient is non-ambulatory, doesn't have the use of her arms, resulting in being unable to change it herself? I reread the OP's posts and don't see anything of the sort mentioned...the question was about if it would be comfortable?

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
Side note: How does one get a perianal burn?? I am trying to think of a senario and I just can't.

Unfortunately, only one case came to my mind, a six-year-old girl I took care of dunked in a scalding bathtub intentionally.:crying2: But that could happen with a fall or a decreased LOC I would imagine. Come back, OP!

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A tampon is for comfort.

But off topic, I'd like to know why the patient isn't ambulatory? I've done care on patients before with perineal surgeries and I & Ds, with packing and SEVERE pain. I can tell you now, that foley is MORE of a problem than not.

What's it for? Patient is unable to void? And if the menstrual period is THAT bad--why? Fibroids? Is an emergency D & C warranted?

From the situation from the OP, it's all about comfort. Besides that, what's wrong with her arms? She can't get up? I don't understand this scenario? Is she comatose?

Please explain.

I don't understand how, in a situation with the pt's skin integrity being altered, a tampon can't be seen as an attempt to promote healing and decrease risk of infection. If she is bleeding heavily with her period- and there are people with heavy flows that do not need a procedural intervention- the area is going to stay continually moist. I just don't understand how this can be viewed as only a comfort measure. :confused: I agree in most cases we want to get "out" as much as we can as quickly as we can, but every case isn't text book. I think the foley and tampon are both beneficial to this pts care, even if they are ambulatory.

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
Why is that a bad thing, to be avoided? Isn't morphine a comfort measure, too?

Please, original poster, come back and give us the rest of the storey.

Nothing except she can do it herself. I don't want to participate in a potential infection process.

I can write, "patient inserted tampon."

I don't want anyone to come back at me to tell me, I was the person who caused any sort of infection process.

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