Bladder Irrigation During Transfers

Question#: 691

Question: 

Is undergoing bladder irrigation (Large bag of saline, flushing the bladder via a cath), are we able to transport these pt’s without an escort that can trouble shoot the cath if there is a problem? I have always been told now, but I am wondering if anyone there could point me towards where I could find this out?

Answer:

You are correct that these patients should not be transported while active bladder irrigation is occurring. This is an ongoing procedure that needs to be managed by someone who is trained to troubleshoot and mitigate any issues. Trained personnel should be monitoring color and amount of the output fluids, controlling the drip and flow of the rinse as needed, emptying drainage bags as needed, monitoring for blood clots or debris, and replacing the rinse solution as needed. To note: complications, such as infection and bleeding, seem quite rare and mainly seem to occur during catheter insertion.

Troubleshooting this procedure is out-of-scope for paramedics in our region. However, as per the NOCP Guidelines, both PCPs and ACPs are trained to “demonstrate the appropriate technique when caring for equipment and patients with urinary catheters” and therefore could transfer this patient, with catheter in place but irrigation halted for the duration of transport.

Thank you again for your question and your continued efforts towards patient care in our region.

References:
https://www.uptodate.com/contents/complications-of-urinary-bladder-catheters-and-preventive-strategies?search=bladder%20irrigation&topicRef=8090&source=see_link
https://www.health.gov.on.ca/en/pro/programs/emergency_health/edu/docs/bls_pcs_v3.4.pdf
https://my.clevelandclinic.org/health/treatments/22597-continuous-bladder-irrigation
https://paramedic.ca/documents/2011-10-31-Approved-NOCP-English-Master.pdf