Straight cath or foley cath for labor patients??

shortstuff31117 · Jan 17, 2012

Our epidurals run continuously. Anesthesia only comes to bolus if they need some breakthru pain control. Our pts. usually aren't up for at least 2-4 hours after delivery, sometimes longer if they get a bolus right close to delivery :uhoh3:

NurseNora, BSN, RN · Jan 21, 2012

I don't have the references on hand, but you can Google 'infections after catheter placement" or some thing like that and find lots of references. Multiple straight caths cause less infections than an in dwelling Foley. I don't know if they have come up with a top number of straight caths. Talk with your infection control nurse, she will probably have reference for you.Taking the Foley out during pushing is pretty usual. If left inflates, it can cause serious damage to the urethra as the baby descends.

RNLaborNurse4U · Jan 23, 2012

I can't find the study that shows an increased risk of UTI with the use of a foley, versus use of straight caths. I know I have that study printed out somewhere in this mess of an office/house!!! Anyway, the rationale for using intermittent caths after epidural placement is that there is less trauma to the urethra and bladder, and decreased exposure to bacteria and other organisms. If you have a foley in place, you have that constant irritation of the catheter tube in the urethra (creating micro tears, allowing organisms an entry port into the urinary tract and bloodstream). You also have that constant open port for organisms to travel up the foley catheter into the bladder, by having a continuous catheter in place.

shortstuff31117 · Jan 23, 2012

Talk with your infection control nurse, she will probably have reference for you..

What makes you think we have an infection control nurse?? Haha just teasing, making fun of my hospital really :lol2:

tablefor9, RN · Jan 23, 2012

Since our average primigravid pt gets her (very dense) epidural about 10 hours prior to delivery, we place foleys. If we have a multip at 5-6, we proceed on a case by case basis.

melmarie23, MSN, RN · Jan 24, 2012

our epidurals are continuous as well...but is d/c'd at time of delivery (or after the repair if needed) and I get my pt's up and OOB within 2-3 hours of delivery. Typically, its only due to the time recovering her and monitoring babe because her Aldrete score is usually 8+ by an 1-2 hours (meaning I could get her up then, but the going ons of recovery make it so its a bit longer before I assist her OOB to the bathroom).

melmarie23, MSN, RN · Jan 24, 2012

and prior to the epidural placement, I always try and get my pt's to the bathroom to void. That really helps. And then I'll straight cath before pushing (sooner if its been a few hours since her last void/epidural placement).

jodyangel, RN · Feb 6, 2012

Our patients are bed bound once they receive their epidural. I place foleys in all my laboring pts because esp. if they're primes it can take up to 24 hrs to deliver. Repeated straight cathing every 2-3 hrs is insane. OH and they don't let them out of bed until 6 hrs after epidural is turned off. Had a few falls postpartem apparently...