BLADDER IRRIGATIONPrepared By : Christian Raveina

Definition :• Bladder irrigation means to

flush out the urinary bladder with a liquid

Hazards 1. Infection : urinary tract offer a

favorable environment for the multiplication of bacteria because it is dark, moist & warm . Injury to the mucosa of the bladder leads to growth of the bacteria in bladder. Changing the pH value of urine by medication .force of the flow cause injury .

Hazards 2. Tissue trauma : during the insertion

of the catheter & procedures applied to the bladder , tissue trauma may take place .even the slight movement of the catheter can cause tissue trauma & breakdown .

Hazards 3. Urethral irritation : symptoms

include burning sensation & pain at urethral meatus will be experienced especially by the male pt. due to indwelling catheter

Hazards 4. Bladder spasm : bladder spasm may

occur due to the balloon of an indwelling catheter resting directly on the bladder neck . Forcing fluid more than what is tolerable by the pt. will lead to muscle spasm & pain

Types of catheter used in BI• Straight catheter

RimRing

Side holes

Metal catheter

• Simple rubber catheter Channel

Hole

Self retaining /indwelling /retention catheter • Double lumen foley’s catheter

BalloonHoles

Main channel

valve

Self retaining /indwelling /retention catheter • Triple lumen foley’s catheter

Balloon

Drainage or irrigation hole

Main channel

Channel for balloon with valve

Irrigation channel

Malecot catheter

Pesser catheter /mushroom tip catheter

Purposes • To clean the bladder from

decomposed urine , bacteria, excess of mucus , pus & blood clots & to maintain the patency of urinary bladder

• Relieve the congestion & pain in case of inflammatory condition by the application of heat

Purposes • To promote healing• To prevent the clot formation in case

of bladder surgery • To prevent or treat the infection• To arrest bleeding

Solutions used• Distilled water• Normal saline• Glucose solution 5%• Boric acid 2%• Potassium permanganate 1:10000• Acriflavin 1:10000• Silver nitrate 1:5000• Acetic acid 1:400

Methods 1. Open method : • Open irrigation means that the closed

drainage system must be opened to the environment in order to do the bladder irrigation

• Every time the catheter is disconnected from the drainage tubing to do the procedure

• There is a great risk of introducing bacterial contamination into the urinary bladder

• There is also increased chances of introducing air

• Open irrigation is usually done using an asepto syringe

2. Closed method• To avoid the hazards of bacterial

contamination present in the open system of bladder irrigation , the closed system of bladder irrigation is practiced at present

• Closed system can be a continuous or intermittent irrigation

• The pt. will have a urinary catheter put through the urethra & suprapubic catheter

• The apperatus used for the IV infusion can be used in this method

• It is connected to the urethral catheter• The fluid enters through the urethral

catheter & drain out through the suprapubic catheter

• Clamp are used to regulate the flow of fluid

• When only one catheter is put in , apply clamps for the inflow & outflow tubes

• Opening & closing these clamps alternately allows the fluid to get into the bladder & then to drain out of the bladder

Procedure of CBI• Explain the procedure & prepare the pt.• All individuals who will be helping (caretaker)

should wash their hands with surgical handwash & wear the gloves.

• Position the pt. for easy access to the catheter, maintaining pt. comfort

• Ensure pt. has 3 way catheter • Hang the irrigation flask on Iv pole & prime

irrigation set maintaining asepsis of irrigation set.

• Please confirm the amount with the physician you can introduce. Introduce 75 to 100 ml of solution at a time. If a drip method is used, introduce fluid at a rate of 40 to 60 drops They will also instruct you as to how many times to complete the irrigations, normally they should be done once per day.

• swab irrigation and catheter ports with alcohol swabs & allow to dry

• Open the irrigation lumen of the catheter

• Connect the irrigation set to the irrigation lumen of the catheter

• Ensure urine is draining freely before commencing CI.

• Unclamp the irrigation flask & set the rate of administration by adjusting the roller clamp

• Give proper position to the client • Record the procedure • Handwashing

THANK YOU…