Jan 17, 2018

The "Tactical" Foley

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Arguably one of the most underutilized tools in the tactical medics tool box. With timelines extending, the care of a patient may exceed even your own anticipation. So what does a foley do, and why should you care?

 

According to AACN "Urine production is the result of continuous filtration of plasma through the kidneys, which receive approximately 20% to 25% of the cardiac output. Normally, less than 1% or approximately 1500 mL of the 180 L of plasma filtered daily leaves the body as urine. However, this quantity can vary from 600 to 2500 mL/d. Urine production generally occurs at a rate of 1 to 2 mL/min but can reach a maximum of 20 mL/min and depends on

several factors. Urine volume has a direct relationship with fluid intake and the rate of renal circulation and an inverse relationship with the amount of water lost through other routes. In addition, the volume of urine depends on hydrostatic (blood) pressure; the number of active glomeruli; the permeability of the glomerular membrane; tubule reabsorption, which depends on antidiuretic hormone; and the osmotic pressure within the renal tubules."

 

While there has been debate on the subject, there is little debate that a foley when placed properly will offer significant insight to resuscitation of the patient, as well as allowing for voiding of the bladder which can lead to much larger issues as time progresses.

 

What are your experiences and opinions on the foley catheter's use and function in the PFC setting?

 

(Yes, we know you should wear gloves on in the picture to the right)

 

Fallis W. Crit Care Nurse April 2005 vol. 25 no. 2 44-51

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