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Avoid the poor man’s TURP with a Foley by using POCUS

October 11, 2017

Nurses are really good at putting in Foley catheters. They do it all the time and most of them are really easy to place. Most of them…

When they aren’t, who do they ask for help? You bet ya! The emergency physician. If you are like Dr Lloyd Gordon, the first thing that you do is pick up your probe, and rightly so! Here is a case from Lloyd…

A colleague had a concern with a Foley catheter. The catheter had drained the bladder but there was a question with the balloon placement. I looked at the bladder which was only 2-3 cm wide, no balloon in sight. I asked him to deflate the balloon and insert the Foley a bit further. The bladder completely collapsed with nothing to see.. Some urine had come out of the Foley. He injected the Foley with water and it filled again to 2-3 cm. When the balloon was filled, I could see the balloon. However it was in the prostate.

Deflate the balloon, insert a bit further and the tip of the Foley appeared in the bladder. This time when the balloon was inflated it was clearly surrounded by bladder. The morale: always use POCUS for any problematic Foley insertions.

I am not looking forward to the day when I need a Foley catheter. But if I do need one, you can bet that I will asking asking that the location of the catheter tip before the balloon is inflated 🙂

By the way, similar to how nurses have been shown to be able to use POCUS for placing peripheral IVs, Bladder EDE would be really easy for nurses to learn.

Hope to see a bunch of you this weekend at WCUME 2017 in Montreal!

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