Catheter flushing involves introducing a fluid, typically sterile normal saline, into the urinary catheter to maintain its function. This procedure helps prevent the tube from becoming blocked by debris. The technique uses a syringe to gently instill the solution directly into the catheter tube. Proper flushing ensures continuous urine drainage and patient comfort.
The Primary Goal of Catheter Flushing
Flushing is performed to preserve the patency of the catheter, which is its ability to remain open and functional. The narrow lumen of a catheter can easily become obstructed by the accumulation of sediment, mucus, or blood clots originating from the bladder. When these substances build up, they can form a mucus plug or a biofilm on the inner surface of the tube.
A blocked catheter prevents urine from draining, which causes discomfort, bladder spasms, or abdominal pain. Blockage also increases the risk of complications, including urinary tract infections (UTIs), because urine retention allows bacteria to multiply. By instilling a sterile solution, the flushing procedure mechanically washes away debris, restoring urine flow and mitigating these health risks.
Determining the Correct Flushing Schedule
The frequency of catheter flushing must be determined by a healthcare provider. Routine, prophylactic flushing of indwelling urethral catheters is generally not recommended because it can increase the risk of introducing infection. Instead, flushing is often performed on an as-needed basis when signs of an obstruction appear, such as decreased or absent urine output.
However, some patients require a scheduled regimen due to specific medical conditions that increase the risk of blockage. Patients with a history of recurrent blockages, hematuria (blood in the urine), or excessive mucus production may be prescribed daily or twice-weekly flushing. Catheter type also influences the schedule, as suprapubic catheters, which are surgically placed through the abdomen, may have different flushing requirements than a standard urethral Foley catheter. A physician must prescribe the exact frequency and volume of flushing solution based on the patient’s unique health profile and the type of catheter in use.
Step-by-Step Guide to the Flushing Procedure
Performing a catheter flush requires sterile technique to prevent the introduction of bacteria into the urinary system. The procedure begins with gathering the necessary supplies: a sterile flushing solution (usually 0.9% normal saline), a catheter-tipped syringe, and clean or sterile gloves. The solution should be brought to room temperature before use, as cold fluid can cause discomfort or bladder spasms.
Before starting, hands must be thoroughly washed, and gloves applied to maintain an aseptic environment. Locate the access port on the catheter tubing and clean the connection site with an antiseptic wipe. After disconnecting the drainage bag, the syringe filled with the prescribed amount of saline (often 30 to 60 milliliters) is connected to the catheter.
The solution must be instilled slowly and gently. Stop immediately if any resistance or pain is felt. After instillation, the plunger is pulled back to gently withdraw the fluid and any debris that may have caused the blockage. This process is repeated until the retrieved fluid appears clear. Finally, a new, sterile drainage bag is connected, and the urine flow is monitored to confirm the obstruction has been cleared.
Identifying When Flushing Needs Adjustment
A decrease in the amount of urine draining into the collection bag, or a complete absence of output over an hour, signals an issue. Leakage of urine around the outside of the catheter, known as bypassing, also suggests the catheter is blocked and needs flushing or replacement.
Other symptoms requiring immediate medical attention include pain in the lower abdomen or flank area, which may signal bladder distention or a severe blockage. The appearance of thick, cloudy, or foul-smelling urine, or the development of a fever, suggests a potential urinary tract infection. If flushing does not resolve the drainage issue, or if these serious symptoms occur, the patient should contact their healthcare provider.