Skip to content

Lines and Catheters

Ahman Dbouk and Samuel Lazaroff

Foley Catheter

  • Indications: urinary retention, close urine output monitoring in critical illness or renal failure, need for strict I&Os (ex: diuresis) and unable to be achieved without catheter, surgery, open sacral/perineal wounds with incontinence, patient comfort at end of life

    • Urinary incontinence alone is not an indication for foley catheter
  • Duration of use is biggest risk factor for CAUTI

    • Best way to prevent CAUTI is to avoid inappropriate placement
    • Assess daily whether foley can be removed
  • Chronic Foleys generally should be exchanged at time of admission

  • Any concern for catheter obstruction (particularly with blood clots) should prompt urgent urology consult for irrigation/intervention (typically after RN has attempted)

  • Difficult foley placement

    • Make sure an attempt has been made with a Coudé catheter. This catheter has a curved tip that can be useful in patients with BPH


  • Single lumen: long term Abx, stable IV access with intermittent draws

  • Double lumen: special populations (ICU or chemo), TPN w/ lipids (incompatible with many IV medications)

  • Risk factors for CLABSI/VTE: ↑↑duration, ↑↑number of lumens, left arm, lower extremity

  • A note on midlines:

    • A midline is just a long PIV inserted into the deep veins in the arm, typically 6-15cm
      • For reference, when you place an US-guided IV, the “long” 18G needles at VUMC are 2.5 inches (~6.4cm)
      • Not much benefit compared to US-guided IV. Useful for stable IV access for meds and fluids. Not a stable route for blood draws


  • Troubleshooting: EGS consult for malposition/not functioning, wound consult for skin breakdown

  • G-tube study: 30mL Gastrograffin via tube [resident often must push], and order KUB

Last update: 2022-06-21 14:45:35