overinflate catheter balloon

[renerian, BSN, RN]

Recently one of our staff was educated on by our "nurse leader" to save money on catheters to routinely overinflate the balloon on a french foley with a 5 cc balloon to fill it with 10cc. This person said that is okay and common practice and was taught this in nursing school. I chatted with my hubby who has over 10 years renal nursing experience and he said it is practiced but not good practice and only done in a pinch and rupture with pieces of the balloon floating around is not good. I have been a nurse almost 20 years have never done this, never seen it or heard of it but I am not a renal trained RN.

Has anyone seen this as a standard of practice? News to me if it is.

renerian

[Berta]

I'm a student, first semester our instructors taught us to inflate with 10 ml also. So, I just went and grabbed my textbook to verify the amount. Guess what it said...inflate the balloon to the amount indicated on the package which can range from 5ml to 30ml.

How would overinflating it save money?

Berta

[frann]

How can that save money? I was allways taught to put 10cc in foley. that's how much comes in the syringes in kit.

[NRSKarenRN, BSN, RN]

ony way you can "save money" by using 10cc fluid in foley catheter is by permitting the cath balloon to be fully inflated to prevent leakage and slipping out bladder.

5cc balloon is meant to hold 5-10cc if patient has bladder spams with 10 cc instilled can decrease to 7.5cc.

30cc balloon not recommended: holds 30-50 cc fluid (still seen in some long term incontinence patients)

rationale:

catheter size

large catheter lumens (> 18 fr) distend the urethra and may irreparably damage the urethra and bladder neck. catheters with 30 ml balloons may also injure the bladder neck and contribute to bladder spasms and leakage. it is recommended that the smallest catheter size adequate to provide drainage be used (usually no larger than a 16 fr with a 5 ml balloon inflated with 10 ml sterile water to ensure symmetry of the balloon) (moore & rayome, 1995). larger lumen catheters are indicated in special situations such as postoperative urologic patients with hematuria to allow clot drainage. the common strategy of increasing catheter size to treat bypassing of urine around the catheter is ineffective and counterproductive. increasing lumen size will traumatize the urethra, possibly obstruct urethral glands, and certainly exacerbate urine leakage.

http://www.medscape.com/viewarticle/467797_4

[color=#995522]care of patients with long-term indwelling urinary catheters http://www.nursingworld.org/ojin/hirsh/topic2/tpc2_1.htm

managing urinary incontinence

great article re bladder products available:

specialist products

www.continence-foundation.org.uk/docs/prodf.htm

catheter 101 review:

ten tips for foley catheter use & care

http://nursing.about.com/cs/renalandurologic/a/aafoleycath.htm

ten tips for foley catheter use and care

a practical approach to catheter-associated problems.

urinary catheter management for the older adult patient

[renerian, BSN, RN]

Thanks everyone for your input. I have always ordered if the doc ordered 10cc instilled in the balloon, a 10balloon not realizing a 5 cc balloon can hold 10cc. This would save money as we had plenty of 5 cc balloons but no 10s. That makes more sense saying it that way than the way I did.

Thanks,

renerian