Irrigating foley catheter

Long Term Care Columnist / Guide · Dec 9, 2003

Most of the Foley irrigations I've done were with an antibiotic solution; however, when we need to unclog one quickly at my hospital, we use sterile water.

I've never thought about it before---this is a good question, BTW---but it seems to me that NS could be irritating to the delicate tissues inside the urethra and bladder, especially if there's already some trauma due to the insertion and presence of the catheter. Also.......whatever solution is used should be warmed to body temperature, as cold solution can cause spasms that are VERY uncomfortable for the patient (to say the least).

nursenatalie, ADN, RN · Dec 9, 2003

We do a lot of irrigations after the CBI has been discontinued following TURPs. The warming of fluid is a good point...of course what we use is room temp but 72 degrees is a great deal colder that 98 and could definitely increase the spasms that the patient is already receiving, wonder if we could just wrap the CBI bag in a blanket and toss it in the blanket warmer? Of course then you run into getting it too hot and burning them up... just thinking out loud here. I will try to pick the urologists brain next time he's on the floor

chris_at_lucas_RN, RN · Dec 9, 2003

Seems like a good way to tell if it is a proper temp would be the old baby bottle inside the wrist technique... A little bit warm might actually feel soothing...

RN-PA, RN · Dec 9, 2003

Our CBI (continuous bladder irrigation) is normal saline. It's weird, but I can't remember what I've used to hand irrigate a foley, but I'm pretty sure the orders have been for normal saline.

As far as warming the saline used for an irrigant, I'd never heard of that before reading it here. Our bottles are at room temperature (I know-- cooler than body temp.) and when a patient needs to be irrigated and is having bladder spasms from passing a clot, I'm not thinking of warming the solution. I'm just moving as fast as humanly possible to irrigate the catheter and bring relief to the patient.

We DO have heating pads for warming peritoneal dialysis solutions which I guess could be draped over normal saline bottles.

bellehill, RN · Dec 11, 2003

I've always used normal saline for hand irrigating a foley. Never thought about warming solution for CBI or hand irrigation...interesting thought.

passionate · Jul 2, 2007

What does the doctor's order say to use as a solution? Sterile water is what the urologists I worked with used. It was warm as well.

meownsmile, BSN, RN · Jul 4, 2007

We use normal saline at the bedside for hand irrigation to remove clots following CBIs. We don't warm fluids though. Haven't ever had anyone complain of bladder spasm because of it although it may be an issue with some patients.

icie rn, ADN, RN · Jul 4, 2007

Used NSS. Room temp is generally fine in colder months but may need chill removed if facility is cooled in summer months.

canadianrpn · Jul 26, 2007

I'd been taught to use sterile water as the normal saline can irritate.....but with the CBI it's never that big a problem. The hospital where I work keeps both normal saline and sterile water bottles of varying sizes in the blanket warmer......and patients do appreciate it.

Cheers

ceecel.dee, MSN, RN · Jul 26, 2007

We learned the any irrigation is done with NS to decrease risk of electrolyte disturbances (that's why CBI is always NS).

kell1566 · Jul 27, 2007

I work on a urology floor and we use nss for cbi and also for irrigation. I never thought of warming it. I don't know if it would be a good idea would think it could possibly burn. Hard to tell the right temp I guess...love urology though!!!