What a Nurse Should Know About Continuous Bladder IrrigationHigher Education Articles September 9, 2013
Continuous bladder irrigation (CBI) is typically used following surgery, to insure that the patient’s bladder remains clear of all sediment and potential blood clots. While it is not overly complicated to set up, it is also not quite as simple as a standard catheter setup. On top of that, there are complications that can arise in even the best of circumstances.
Continuous Bladder Irrigation: The Basics
CBI typically uses a 3-way Foley catheter in order to:
•Inflate catheter balloon
•Provide irrigation solution
Depending on many things concerning the patient’s situation, the catheter may need to be drained and irrigated every 20 minutes to every several hours.
Why Constant Care is Needed?
Most Continuous bladder irrigation treatments are prescribed immediately following surgery, and most post-operative care specialists see this as a necessary safety procedure. CBIs are especially good at handling the kind of clot retention that may pop up after transurethral prostatectomy surgery, where it is an all-too-common complication.
Of course, this isn’t the only case where a CBI may be used. It may be used in many cases in order to avoid hypotonic bladder problems (such as failure to void) after surgery and post-op bleeding, clotting, and clot retention.
This requires special vigilance on the part of the nursing team to ensure that the irrigation constantly flushes out any clots or other sediment or debris in the patient’s bladder.
The catheter must be drained and irrigated at intervals provided by the surgeon or post operative care specialist. But, it is also important for all nursing personnel involved with the patient to check the catheter and the patient’s vitals on a more frequent basis, in order to avoid complications with the irrigation.
One reason to constantly monitor the patient is because their bladder may be working overtime to clear the body of excess elements (such as potassium and sodium), especially in the case of men after a prostate procedure. This can require more flushing than usual.
The outpour may seem blood-red at first, but this is often only at first. While it is never a bad idea to call on a doctor when this happens, keep in mind that it is not uncommon and not any reason to panic!
It’s also important to make sure that the patient stays irrigated, and his or her catheter stays drained. One key to this is seeing to it that the outpour of the catheter remains unblocked from any clots or other sediment that may have found their way through.
Failure to do so can have very negative consequences for the patient. One recent mistake in a hospital that will go unnamed, lead to the patient’s catheter backing up, which lead to the patient coding more quickly than the staff would have thought possible!
The patient was cold to the touch and, while he ultimately ended up okay, the story might not have had a happy ending in other circumstances. At the very least, that kind of rapid change and danger can put a patient’s heart at risk, now and in the future. Simply make sure that your patient’s continuous bladder irrigation is consistently monitored and cared for at all times, and everything should be fine!