Page 2 (read page 1 for important warnings first)
Posterior Nose Bleed: Foley Catheter Procedure
A Foley catheter is two hollow rubber tubes combined. At one end, the combined tubes taper, and one can be blown up like a balloon. At the other end, you’ll find two openings, one of which you can attach to a syringe filled with air. Then you can push the air into the balloon.
If you’ve never inserted a tube before, my description may be hard to follow. To help with visualization, here’s a video.
It’s best to test the balloon to make sure it’s working before inserting the catheter. You can suck the air back out with the same syringe.
- Trauma to the delicate nasal lining. Be as gentle as you can.
- Bleeding as a result of trauma.
- Infections, even abscesses, which may require antibiotics.
- Sinus infection (because of stopping up the sinus openings), which may require antibiotics.
- Place the catheter up to the side of the face to approximate the length needed to go from the nostril around and down to the opening to the throat.
- Mark the length with a piece of tape or a marker.
- Coat the tapered end and about four extra inches with some sort of lubrication, preferably water-soluble, such as K-Y Jelly. Otherwise, you can use antibiotic ointment, petroleum jelly, or whatever lubricant you have available.
- Gently, but firmly, insert the tapered end in a nostril. Tilt the tube so you can keep the curve going slightly downward, and push.
- You’re going to feel some resistance when the tip reaches the narrowest part of the nostril. Push a little harder but don’t force it. That’s a good way to cause more trauma and an additional nose bleed, this time caused by the procedure.
- If you don’t think it’s going, pull out the tube, reposition, and try again.
- If you get the tip past the narrowest area, it should become easier to push.
- Stop when you come to the area you marked when you approximated the length.
- Now blow up the balloon. Foley balloons usually hold about 30 ml (cc) of air or liquid, but you only need to put in around 10 ml—no more than 15. And use air rather than liquid in case the balloon leaks.
- Pull the tube, with the blown-up balloon, back out until you feel resistance.
- At that point the balloon should be putting pressure on the back of the nostril—the area you couldn’t get to with the packing I described in the previous post.
If the nose bleed stops, tape the catheter to the face so it won’t move, and keep it in for 72 hours. Be sure to suck the air out of the balloon before pulling it out.
If the nose bleed doesn’t stop, skip to the last section in this post.
Photo: Flickr/Michael Tam.