The first night with the CBI started out fine. The irrigation was flowing into the bladder
and it was flowing out like it should.
There were no clots in the urine so that was a good sign. In order to keep track of the CBI, the urine
is emptied every hour just to keep an eye on the output.
About halfway through the night, I noticed the catheter was
not draining as much as it should have been.
In fact it didn’t look like it was draining at all. So I decided it needed to be flushed. When I flushed the catheter, I got a bunch of
blood clots that had been clotting off the catheter. As soon as it was flushed it started draining
perfectly again. It was fine for the
rest of the shift.
The second night was horrendous. During the day shift, the urology residents
had turned the flow down to almost a slow trickle. The thing about this is that when you do that
you actually allow more blood clots to form because there is nothing irrigating
them out. Everything seemed to be going
fine, until about 0300 when the catheter was clotted off again. So I flushed it again, but this time even
though I got out some of the clots, I couldn’t get it to flow again. So I called the doctor to see if I should
turn it up. He told me to leave it
alone. So I left it alone and kept an
eye on it. At 0500 the urology residents
showed up and they were pissed. They
went off about how it was a bad thing to let it get clotted off and I should
have flushed it and should have turned up the rate and “manA I just did
everything wrong”. It was frustrating
especially since I had spoken to the doctor but I just shrugged it off and went
with the flow. Apparently it was clotted
off to the point of they had to flush it for almost thirty minutes before they
got it flowing. Hmm…probably would have
been nice if the rate would have been turned up some. Thankfully the patient was fine and no harm
was caused.
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