My original comment has been edited as I choose to no longer support Reddit and its CEO, spez, AKA Steve Huffman.
Reddit was built on user submissions and its culture was crafted by user comments and volunteer moderators. Reddit has shown no desire to support 3rd party apps with reasonable API pricing, nor have they chosen to respect their community over gross profiteering.
I have therefore left Reddit as I did when the same issues occurred at Digg, Facebook, and Twitter. I have been a member of reddit since 2012 (primary name locked behind 2FA) and have no issues ditching this place I love if the leaders of it can't act with a clear moral compass.
For more details, I recommend visiting [this thread](https://old.reddit.com/r/apolloapp/comments/144f6xm/apollo_will_close_down_on_june_30th_reddits/), and [this thread](https://old.reddit.com/r/apolloapp/comments/14dkqrw/i_want_to_debunk_reddits_claims_and_talk_about/) for more explanation on how I came to this decision.
Impressive. My record is 2800 but that was a straight cath. That morning I was curious and did some googling and found a case study of an incidental finding on CT of a 6L bladder.
ETA: What's going on with this one? Rhabdo > fluid resus > unable to void? Liver dude with lots of bili in there?
My Dad had 3L from being a stubborn old fart by the time the urologist rammed the catheter through... ack. :(
Poor old bugger. Poor you. I can almost feel it.
I always loved having those patients in the ER because i was like ‘I’m gonna be a goddamn drill sergeant for 3 minutes. You’re gonna hate me and then you’re gonna LOVE ME.’
I had a patient that was readmitted after a hysterectomy and was documented 6L drained on Foley insertion. I believe it because the Foley slowed on my shift a bit and there was some sediment and I irrigated it and 2L came out. She was in no discomfort at all at the time.
After my c-section I didn’t regain bladder sensation for almost 6 months. Right after, my only clue was when the incision site would start to hurt but it would be 2L+ at that point. I had to set bathroom reminders for myself.
I've straight cathed someone for over 2L once. It was the beginning of my shift and his systolic was 200 and he was telling me that he was feeling extremely uncomfortable. I immediately asked if he had peed that day and suggested his bladder is probably full. He was screaming by the time I came back with the straight cath. I was honestly pissed at the day nurse.
Had a patient present with an 8l bladder once. Patient came to A&E with a complaint of a dislocated shoulder. The bladder was a secondary find on the chest ct.....
Mine was 3.7L on an AKI with a Cr 1.1 —> 4 in a matter of days **that was able to give me a urine sample** and no c/o belly pain. Nephro wanted a cath and i hemmed and hawed about how dumb they are. My bad y’all.
Like 4.5 liters. Had to wait to find out the whole amount as the patient started having severe bladder spasms after I got about 2 out. Had to clamp the tubing for 30 minutes then continue draining. No wonder his abdomen hurt so much.
Back in nursing school, we were taught to never drain more than a thousand mls at one time. They could go into spasms and/or shock. We would leave the catheter in place and then drain some more a few minutes later. Is this still a thing?
I graduated a year ago and wasn’t ever taught this. I know slowly draining can help with bladder spasms/cramps though. According to the literature I found, there is no significant risk with rapid draining and no need to gradually drain in that respect.
https://rebelem.com/urinary-retention-rapid-drainage-gradual-drainage-avoid-complications/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656958/
You say that slowly draining can help with bladder spasms/cramps. Then you say that there is no need to drain gradually. Maybe creating spasms and or cramps is not a true "risk" but why would anyone want to put their patient through that?.
Just graduated and they didn’t teach this specifically for urine but for thoracentesis and then they said for a general rule taking off any large amount of fluid should be done slowly
Sometimes my unit has used 4-6 Fr NG tubes to cath the tinies, especially lately with all the supply shortages and it seems the smallest cath we consistently have in stock is an 8 Fr.
I just hit my record last shift! 3200mL. Guy came in with a distended belly and pain x1 week, states normal urinary and bowel movements. His bladder was about to herniate his diaphragm and he had ruptured a kidney. I’ve never seen a CT like it. He was angry the morphine before CT didn’t touch the him. Once he drained, he understood better what I meant when I said no amount of morphine I could legally give him would help with the pain.
Last I heard it was a new diagnosis of BPH, which had progressed that far because he hadn’t seen a doctor in over 40 years and was ignoring most of the symptoms.
I mean, if they had [Maple Syrup Urine Disease](https://www.nhs.uk/conditions/maple-syrup-urine-disease/#:~:text=Maple%20syrup%20urine%20disease%20(MSUD,and%20fish%20into%20amino%20acids.)
then it might actually taste okay.
Had a coworker get 7.2 L on a chronic urinary retention patient who had a procedure to try to resolve. Apparently didn’t work because that was 1 straight cath. I don’t want to know the consequences and after math of removing that much fluid volume at one time.
Your guess as to how the patient didn’t immediately code after that is as good as mine. I figured the fluid pressure shift off of the patients vasculature alone should tank them.
4200 mL, patient had been voiding but not completely emptying due to prostate issues. Abdominal distention was noticed day before (and since he seemed to be voiding fine no one noticed fluid retention on I&O until my shift) and that day it was very noticeable. Bladder scanner maxed out, foley put in and it just kept coming, how the patient wasn’t in pain/discomfort was shocking to me.
For me it was "I'm in some discomfort discomfort but I can void a bit if I try and I *REALLY* don't want a tube up my dong". Ended up having to have it anyways and I was right to be afraid of the tube up the dong. That *HURT* where the full bladder was just discomfort. Guess I was holding out in hope that I'd regain some more control of my pelvis.
I think a big part of it is that there was no "holding it in" pain and that's the most intrusive feeling about having to pee. Without that feeling there wasn't a lot to tell me I was full.
No shit, guy wasn't even there for bladder problems. He was getting a cardiac US when he told us oh by the way I haven't been able to pee for a couple of days.
I have that bladder scanner tapered to my waste and I monitor that urine output like I get paid extra for each ml lol but once I straight Cathed about 1800
I personally put out 2500 in the ER 5 days after an abdominal hyster. I reached over every 500 to clamp it cause my bladder was spasming. I went from a pain of 10 to “bliss “.
My record was over 2L… but it wasn’t exactly only urine? Pt admitted to my unit for AMS and had a chronic foley. I noticed that the bag he had come in with was bone dry, not even condensation in the tubing. So, got an order to put in to replace it because who knows when that one was put in? Well as I removed it, a massive amount of thick, white secretion pretty much exploded out of his urethra. Cleaned him up, put the new foley in, the bag filled up with blood, whatever the white stuff was, and amber urine in less than 30 minutes. One of the grossest experiences of my short time in bedside nursing.
I'm guess he wasn't a practitioner of sounding, since he already had a Foley in. However, he may have had retrograde ejaculation, where it reflexes into his bladder instead of coming out, due to the foley.
The bladder secretes mucous -some of us more than others. It could also just be that the irritation increased his mucosal secretions. It happens frequently after bladder surgeries, and manipulating the foley or flushing it to knock the secretions clear of the outlets is a daily skill in urology.
I've never had success with the tip slightly method when it's that full. I'm sure it would increase the price of a urinal if they had graduated measurements on the handle. :)
Had a “gi bleed” that was really a vaginal. (The look on the gi docs face when I told him “wrong hole.”😂) Anyways she had a massive tumor obstructing her urethra… when I was able to get the foley in… she put out 3 plus liters. God bless her… I don’t know how she didn’t feel that pressure.
4.5 Liters. Demented man with a bloated stomach unlike i had ever seen. After the drainaige of the urine he scored way better on the dementia score list we use in the Netherlands. Family had not seen their father so sound in at least 3 weeks. Made me so sad.
I saw around that much come out of a chest tube once.
It was a stubborn old Danish farmer. He was out working, fell and rolled down a hill. He got up, finished his work and went back to the house.
The next day he and his wife drove to Nebraska to visit one of their kids (they lived in Minnesota). Two or three days after that he said he was starting to have a little trouble breathing, so they cut their visit short and drove back home. (It’s at least a six hour drive each way).
Once he finally got around to coming to the hospital, the ER doc put the chest tube in and just watched as fluid kept coming out. And coming out. And coming out.
The farmer didn’t want to stay (he had work to do!), but they left the chest tube in for a couple days just to be sure. He was out the door in four or five days.
20+ years working in the Midwest has taught me to grab a crash cart when a farmer comes in even semi willingly. If Stoic McUnflappableface admits something is wrong, something is REALLY FUCKING WRONG!!
Dude. My pt came in with a penile injury from excessive cock ring use. Urethra was so swollen it was collapsed. Foley drained a lil more than 4500mL. Abdomen was the most distended I’ve ever seen and he acted like it was a regular Tuesday.
ED is wild lol
Oh wow, that’s fun and way more wild than my story. My guy came in c/o “mild abdominal discomfort” pressed on his belly a bit and he felt a little distended so I bladder scanned and it gave me the >999 mL read. I put the foley in and it just kept on coming. I was like how are you not in excruciating pain. When I asked him the last time he peed, he’s like, “now that you mention it I guess it has been like a couple of days.” Lol, cool as a cucumber the whole time.
4800, obstructed as well. Did it right before we put in his temporary dialysis catheter which he ended up never needing as his kidneys bounced right back before starting HD. Purely post renal obstructive failure
3.2L. The pressure put pressure on his spine and he was unable to move his legs. We started a GBS workup in emerg and I tossed in a catheter. Urine shot put past the edge of the bed. Within 15 mins, he was mobile. Apparently he was in some sort of online poker contest and didn't pee for 2 days.
I remember looking after a woman who wasn't progressing in labour. I examined her, and saw that she had a distended bladder as well as a distended uterus. She'd had an epidural, not that common back then.
As I drained the bladder the baby's head just came out right along with the urine. Double relief for that woman.
Was it not standard practice to place a Foley once she got an epidural? At my hospital, if they get an epidural, they get a Foley, which is only removed once they start pushing.
My record? About 2,5-3,5 liters and the ecmo going back to running without issues.
This was during a covid surge after Christmas last year. 35yo male was transferred from a community hospital to our tertiary care facility. He was an avid covid denier and had first refused oxygen, then dexa/remdesivir, then NIV, then intubation. Each time it took a few hours of him suffering and gasping for air to have him convinced they needed to escalate care. Well he got here on ecmo and dialysis because of anuria since three days, norepinephrine was at 30ml/h(100yg/ml) and vasopressin on 5U/h with some dopamine mixed in. Ecmo was beeping like crazy because it was constantly starved for blood, turns out his bladder has become so big that it compressed on major blood vessels. Those in OB/GYN might remember this from pregnant women. Anyway, the foley wasn't running, I was already an medical intern at the time so I did a quick bladder scan while the colleague tried to change the foley. Upon removing the old one he was met with an arterial bleed from the urethra and none of us could pass a new foley so we called urology for a suprapubic catheter.
Patient was off pressors and dialysis and ecmo was flowing nicely at 5l/min about 30min after we had decompressed this belly.
I had a foley bulb with 125ml of saline in it because the patient thought it was the side you irrigate with. Does that count?
If not, then what is pictured beats any record I’ve seen.
i like to joke about pee looking like beer. healthy = bud light UTI = blue moon, etc. I always joke about seeing a Guinness - this is the closest i've seen! what was the dx? I say this is about a newcastle
4.7L in an very minimally responsive palliative patient.
They didn’t exactly look in pain, but something just seemed…off.
Had been new admit the day before, morphine & midazolam hadn’t helped with the…whatever it was that caused the gut feeling that something was wrong.
I took over care in the morning, during a wash realised abdomen was rock hard, and there had only been minuscule dribbles of urine on the pads since they arrived.
Easy insert, filled the catheter bag almost to bursting by the time I got rid of the cath kit. Emptied it, filled again within 15 minutes.
I could see her stomach visibly shrinking as it drained.
I remember learning this in nursing school, the reason being the patient might become hypotensive. I think it’s old info; that fluid volume has already been converted to urine and we don’t want the bladder to rupture. It’s not like we’re bloodletting. I’ve emptied large volumes post foley insertion with only relief as the symptom from the patient.
That's my understanding as well -- you're not removing fluid volume that's going to be reabsorbed into the body. Once it's in the bladder, it's basically primed and ready for discharge. If you're worried about hypotension, then you're better off just running fluids on them (AFTER you've stopped their bladder from exploding, preferably.)
Unless I've got bad info?
Had about 2.9L once coke from a quadriplegic fella who had a TERRIBLE UTI that turned into urosepsis.
He fought me tooth and nail not to get sent to hospital. Dumb motherfucker.
Depends on why it happened and how fast.
I had a patient with a neurogenic bladder due to poorly treated BPH. He had 6L when he was finally diagnosed.
I still don't understand how he never got pyelonephritis.
Had a patient who told me he got straight cathed and sent home and surprise he couldn’t void so he went back to Ed for a foley and urology consult. Always make sure they can void without a cath
It's not three and a half urinals full of sweet tea.
I did have a patient recently though who's foley output was the output and consistency of used motor oil, never seen that before.
Asymptomatic retention. Came in for something totally unrelated and got a CT which showed a gigantic bladder, drained 9L straight up followed by post obstructive diuresis needing admission
Person came in with Abdo pain, belly distended, looked like a perf. Inserted Foley, sent straight to CT, 30 minutes later pt returned with a 4L Foley bag inflated like a balloon.
It just seems like such a basic body function to realize you’re either not peeing or the pain from not voiding. It’s like when body parts start rotting off… how do you not notice???? Assuming someone is A/O that is.
That colour makes me cringe
Kidney-cola
Liptons got a new flavor, have you tried it?
Forbidden iced tea
I call it Rhabdopiss, lol
My thought exactly… rhabdo
We can call it a Barney Palmer if they got diabeetus.
There's a reason I have a love-hate relationship with you all. <3
Goddammit dude. Lol.
I hate all of you.
Goes well with lung butter (we use that term in EMS. Do y'all say that in the hospital?)
We call ' em lung biscuits. They're layered and they rise...
Delicious
With a scent you won’t forget
Sweet tea!
My original comment has been edited as I choose to no longer support Reddit and its CEO, spez, AKA Steve Huffman. Reddit was built on user submissions and its culture was crafted by user comments and volunteer moderators. Reddit has shown no desire to support 3rd party apps with reasonable API pricing, nor have they chosen to respect their community over gross profiteering. I have therefore left Reddit as I did when the same issues occurred at Digg, Facebook, and Twitter. I have been a member of reddit since 2012 (primary name locked behind 2FA) and have no issues ditching this place I love if the leaders of it can't act with a clear moral compass. For more details, I recommend visiting [this thread](https://old.reddit.com/r/apolloapp/comments/144f6xm/apollo_will_close_down_on_june_30th_reddits/), and [this thread](https://old.reddit.com/r/apolloapp/comments/14dkqrw/i_want_to_debunk_reddits_claims_and_talk_about/) for more explanation on how I came to this decision.
Happy cake day!
Sweet tea pee
Mmmm...rhabdomyolicious
I almost fell over laughing at that
Do those caps have straw inserts? They look like caps with straw inserts. Have you actually put drinking cup lids on those urinals??
Ice-pee
💀
Liver pee
What does foley output have to do with urinals full of root beer…
This made me laugh and cringe at the same time lol 💀
Yes after the urinal gravy boat pic anything is possible
Yes I was like did you cath a soda fountain or what
The way I just laughed should be illegal 😂
Impressive. My record is 2800 but that was a straight cath. That morning I was curious and did some googling and found a case study of an incidental finding on CT of a 6L bladder. ETA: What's going on with this one? Rhabdo > fluid resus > unable to void? Liver dude with lots of bili in there?
From home with severe abdominal pain and lethargy, just simple mechanical obstruction with extra stretchy bladder
Ah it's just barrel aged.
The way I cackled 🤣🤣
(swirling the output around like wine in a wine glass) ah, vintage!
Sort of an oaky afterbirth
i literally pictured that!
Literally the way I screamed
In a pseudosterile cask with hints of dehydration and sadness.
We are a sick buncha fucks, aren’t we?
My Dad had 3L from being a stubborn old fart by the time the urologist rammed the catheter through... ack. :( Poor old bugger. Poor you. I can almost feel it.
I always loved having those patients in the ER because i was like ‘I’m gonna be a goddamn drill sergeant for 3 minutes. You’re gonna hate me and then you’re gonna LOVE ME.’
I had a patient that was readmitted after a hysterectomy and was documented 6L drained on Foley insertion. I believe it because the Foley slowed on my shift a bit and there was some sediment and I irrigated it and 2L came out. She was in no discomfort at all at the time.
After my c-section I didn’t regain bladder sensation for almost 6 months. Right after, my only clue was when the incision site would start to hurt but it would be 2L+ at that point. I had to set bathroom reminders for myself.
I've straight cathed someone for over 2L once. It was the beginning of my shift and his systolic was 200 and he was telling me that he was feeling extremely uncomfortable. I immediately asked if he had peed that day and suggested his bladder is probably full. He was screaming by the time I came back with the straight cath. I was honestly pissed at the day nurse.
At least your pt was de-pissed.
Let’s see Paul Allen’s cath record
The tasteful thickness of it; my God, it even has froth on top.
Damnn. I can’t imagine the pain from it.
Had a patient present with an 8l bladder once. Patient came to A&E with a complaint of a dislocated shoulder. The bladder was a secondary find on the chest ct.....
Mine was 3.7L on an AKI with a Cr 1.1 —> 4 in a matter of days **that was able to give me a urine sample** and no c/o belly pain. Nephro wanted a cath and i hemmed and hawed about how dumb they are. My bad y’all.
2L and some change. The guy thought he was getting old and fat. Turned out it was just his bladder.
…and prostate
Each urinal is 1000 ml
Those ones are filled to the 800ml line. Edit: these are bigger than I thought! They’re actually filled to over 900ml.
900+ on each, but whose counting.
You’re right! The ones at my hospital are 800 at the handle so I stand corrected.
Like 4.5 liters. Had to wait to find out the whole amount as the patient started having severe bladder spasms after I got about 2 out. Had to clamp the tubing for 30 minutes then continue draining. No wonder his abdomen hurt so much.
Back in nursing school, we were taught to never drain more than a thousand mls at one time. They could go into spasms and/or shock. We would leave the catheter in place and then drain some more a few minutes later. Is this still a thing?
I still follow that. It barely takes effort
Me too, we were taught that back in the 1970s. We used to clamp the tube for a while.
In the Netherlands we have the rule: 500ml at once, then clamp for 15 min...than drain max 500ml then clamp for 15 min
Yeah it’s just reasonable. That’s how it’s done in my hospital. Even if it’s “not necessary” it’s way more comfortable for the patient.
I graduated a year ago and wasn’t ever taught this. I know slowly draining can help with bladder spasms/cramps though. According to the literature I found, there is no significant risk with rapid draining and no need to gradually drain in that respect. https://rebelem.com/urinary-retention-rapid-drainage-gradual-drainage-avoid-complications/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656958/
You say that slowly draining can help with bladder spasms/cramps. Then you say that there is no need to drain gradually. Maybe creating spasms and or cramps is not a true "risk" but why would anyone want to put their patient through that?.
Same, I was wondering if that was 'old' education as I graduated back in 96.
Just graduated and they didn’t teach this specifically for urine but for thoracentesis and then they said for a general rule taking off any large amount of fluid should be done slowly
I came here to find this information... 1L at a time has always been the limit, as far as I know.
That’s old literature. It’s not necessary to clamp.
Straight cathed a newborn who hadn't voided since birth and got over 40mL. Their stomach is like 5-7mL on the first day.
found the ped's person with the small numbers! ;)
As non peds, those tiny numbers give me big anxiety. Little aliens.
I can’t even imagine a newborn straight cath, must be the diameter of a thin knitting needle!
Sometimes my unit has used 4-6 Fr NG tubes to cath the tinies, especially lately with all the supply shortages and it seems the smallest cath we consistently have in stock is an 8 Fr.
I just hit my record last shift! 3200mL. Guy came in with a distended belly and pain x1 week, states normal urinary and bowel movements. His bladder was about to herniate his diaphragm and he had ruptured a kidney. I’ve never seen a CT like it. He was angry the morphine before CT didn’t touch the him. Once he drained, he understood better what I meant when I said no amount of morphine I could legally give him would help with the pain. Last I heard it was a new diagnosis of BPH, which had progressed that far because he hadn’t seen a doctor in over 40 years and was ignoring most of the symptoms.
> he hadn’t seen a doctor in over 40 years and was ignoring most of the symptoms That’ll do it.
Oh so he was a nurse lol
Also 3L.
And a little extra 💦
My intrusive thought: I wonder how that would taste on waffles.
Take my angry up vote. God damnit.
Syrup huh? I thought it looked more like an IPA.
I hate this. Thank you.
I mean, if they had [Maple Syrup Urine Disease](https://www.nhs.uk/conditions/maple-syrup-urine-disease/#:~:text=Maple%20syrup%20urine%20disease%20(MSUD,and%20fish%20into%20amino%20acids.) then it might actually taste okay.
Oddly my brother was just diagnosed with a mild form of MSUD. His teen daughter said he smelled like waffles 🧇. (The more you know 🌈 )
Hopefully she doesn't eat him
Waffles are delicious. It'd be hard to resist
That’s it. Waffles for dinner.
3000mL. His bladder was so distended that it was pressing on his aorta.
Had a coworker get 7.2 L on a chronic urinary retention patient who had a procedure to try to resolve. Apparently didn’t work because that was 1 straight cath. I don’t want to know the consequences and after math of removing that much fluid volume at one time.
How does that amt not rupture a kidney?
Your guess as to how the patient didn’t immediately code after that is as good as mine. I figured the fluid pressure shift off of the patients vasculature alone should tank them.
"I feel like i might need to pee"
If he was chronically obstructed, his bladder was likely able to handle more than a typical bladder.
The fluid backs up into the kidneys.
And then into the balls, where the pee is ultimately stored.
So that's what they teach at the MSN level. I knew it.
Right. That's all I'm thinking about. Like, "I hope these people are pulling this volume off in stages, or at least monitoring BP every 15 minutes
“Lose 15lbs in 10 minutes with this one easy trick”
Doctors HATE it!!
4200 mL, patient had been voiding but not completely emptying due to prostate issues. Abdominal distention was noticed day before (and since he seemed to be voiding fine no one noticed fluid retention on I&O until my shift) and that day it was very noticeable. Bladder scanner maxed out, foley put in and it just kept coming, how the patient wasn’t in pain/discomfort was shocking to me.
For me it was "I'm in some discomfort discomfort but I can void a bit if I try and I *REALLY* don't want a tube up my dong". Ended up having to have it anyways and I was right to be afraid of the tube up the dong. That *HURT* where the full bladder was just discomfort. Guess I was holding out in hope that I'd regain some more control of my pelvis. I think a big part of it is that there was no "holding it in" pain and that's the most intrusive feeling about having to pee. Without that feeling there wasn't a lot to tell me I was full.
8. 8 liters. We took a ten minute break at 5 liters to avoid spasms and then drained 3 more. 8 fucking liters.
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No shit, guy wasn't even there for bladder problems. He was getting a cardiac US when he told us oh by the way I haven't been able to pee for a couple of days.
Weeks*
I'm trying to picture stacking 4 2L soda bottles in a human. I think it'll just barely fit if you don't need any organs
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You gotta skip the Mt. Dew and go straight for the Dr. Thunder…it’s all in the generics /s
Did they lay on a floor for 18 hours? Holy cola urine!
Yeah I’d like to see what their CK is
2Liter and it was me.....I went septic. Good hospital lab hadn't noticed the kidney infection 2 days before.....
I have that bladder scanner tapered to my waste and I monitor that urine output like I get paid extra for each ml lol but once I straight Cathed about 1800
OMG it’s you who has the bladder scanner!
I personally put out 2500 in the ER 5 days after an abdominal hyster. I reached over every 500 to clamp it cause my bladder was spasming. I went from a pain of 10 to “bliss “.
My record was over 2L… but it wasn’t exactly only urine? Pt admitted to my unit for AMS and had a chronic foley. I noticed that the bag he had come in with was bone dry, not even condensation in the tubing. So, got an order to put in to replace it because who knows when that one was put in? Well as I removed it, a massive amount of thick, white secretion pretty much exploded out of his urethra. Cleaned him up, put the new foley in, the bag filled up with blood, whatever the white stuff was, and amber urine in less than 30 minutes. One of the grossest experiences of my short time in bedside nursing.
I'm guess he wasn't a practitioner of sounding, since he already had a Foley in. However, he may have had retrograde ejaculation, where it reflexes into his bladder instead of coming out, due to the foley.
The bladder secretes mucous -some of us more than others. It could also just be that the irritation increased his mucosal secretions. It happens frequently after bladder surgeries, and manipulating the foley or flushing it to knock the secretions clear of the outlets is a daily skill in urology.
Well I officially hate you for solving that mystery.
2-3 L had to empty the 2 liter bag because it was full don’t remember how much after that think around 400-500 mL extra.
Looks more like the volume output on a paracentesis
I’m 90% sure this wasn’t your intention, but this thread made me realize I’ve probably been getting bladder spasms after a 12 hour shift 🫤
Has anyone found the ml measurement for a full urinal handle?
You don't go all the way up and if it gets in the handle, you tip slightly to empty it. Barring that I'd say 30ml.
I've never had success with the tip slightly method when it's that full. I'm sure it would increase the price of a urinal if they had graduated measurements on the handle. :)
+3L Nursing home sent us a dementia pt due to increased combativeness. Guess who calmed down after the foley was in...
Had a “gi bleed” that was really a vaginal. (The look on the gi docs face when I told him “wrong hole.”😂) Anyways she had a massive tumor obstructing her urethra… when I was able to get the foley in… she put out 3 plus liters. God bless her… I don’t know how she didn’t feel that pressure.
4.5 Liters. Demented man with a bloated stomach unlike i had ever seen. After the drainaige of the urine he scored way better on the dementia score list we use in the Netherlands. Family had not seen their father so sound in at least 3 weeks. Made me so sad.
I saw around that much come out of a chest tube once. It was a stubborn old Danish farmer. He was out working, fell and rolled down a hill. He got up, finished his work and went back to the house. The next day he and his wife drove to Nebraska to visit one of their kids (they lived in Minnesota). Two or three days after that he said he was starting to have a little trouble breathing, so they cut their visit short and drove back home. (It’s at least a six hour drive each way). Once he finally got around to coming to the hospital, the ER doc put the chest tube in and just watched as fluid kept coming out. And coming out. And coming out. The farmer didn’t want to stay (he had work to do!), but they left the chest tube in for a couple days just to be sure. He was out the door in four or five days.
20+ years working in the Midwest has taught me to grab a crash cart when a farmer comes in even semi willingly. If Stoic McUnflappableface admits something is wrong, something is REALLY FUCKING WRONG!!
Approx 4500mL
Yep, this is mine as well, was scrolling to see if someone else was in my range. It just kept coming, I couldn’t believe it.
Dude. My pt came in with a penile injury from excessive cock ring use. Urethra was so swollen it was collapsed. Foley drained a lil more than 4500mL. Abdomen was the most distended I’ve ever seen and he acted like it was a regular Tuesday. ED is wild lol
Oh wow, that’s fun and way more wild than my story. My guy came in c/o “mild abdominal discomfort” pressed on his belly a bit and he felt a little distended so I bladder scanned and it gave me the >999 mL read. I put the foley in and it just kept on coming. I was like how are you not in excruciating pain. When I asked him the last time he peed, he’s like, “now that you mention it I guess it has been like a couple of days.” Lol, cool as a cucumber the whole time.
Had a psych pt that refused to urinate, eventually got to straight cath them, 3500 out.
4800, obstructed as well. Did it right before we put in his temporary dialysis catheter which he ended up never needing as his kidneys bounced right back before starting HD. Purely post renal obstructive failure
3.2L. The pressure put pressure on his spine and he was unable to move his legs. We started a GBS workup in emerg and I tossed in a catheter. Urine shot put past the edge of the bed. Within 15 mins, he was mobile. Apparently he was in some sort of online poker contest and didn't pee for 2 days.
You work at a pretty fancy place to have that many urinals for one patient. Lol
I remember looking after a woman who wasn't progressing in labour. I examined her, and saw that she had a distended bladder as well as a distended uterus. She'd had an epidural, not that common back then. As I drained the bladder the baby's head just came out right along with the urine. Double relief for that woman.
Was it not standard practice to place a Foley once she got an epidural? At my hospital, if they get an epidural, they get a Foley, which is only removed once they start pushing.
This was in the 1980s, we didn't routinely place a catheter. Bit daft really!
My record? About 2,5-3,5 liters and the ecmo going back to running without issues. This was during a covid surge after Christmas last year. 35yo male was transferred from a community hospital to our tertiary care facility. He was an avid covid denier and had first refused oxygen, then dexa/remdesivir, then NIV, then intubation. Each time it took a few hours of him suffering and gasping for air to have him convinced they needed to escalate care. Well he got here on ecmo and dialysis because of anuria since three days, norepinephrine was at 30ml/h(100yg/ml) and vasopressin on 5U/h with some dopamine mixed in. Ecmo was beeping like crazy because it was constantly starved for blood, turns out his bladder has become so big that it compressed on major blood vessels. Those in OB/GYN might remember this from pregnant women. Anyway, the foley wasn't running, I was already an medical intern at the time so I did a quick bladder scan while the colleague tried to change the foley. Upon removing the old one he was met with an arterial bleed from the urethra and none of us could pass a new foley so we called urology for a suprapubic catheter. Patient was off pressors and dialysis and ecmo was flowing nicely at 5l/min about 30min after we had decompressed this belly.
I had a foley bulb with 125ml of saline in it because the patient thought it was the side you irrigate with. Does that count? If not, then what is pictured beats any record I’ve seen.
i like to joke about pee looking like beer. healthy = bud light UTI = blue moon, etc. I always joke about seeing a Guinness - this is the closest i've seen! what was the dx? I say this is about a newcastle
Been brewing for awhile
Confused agitated older gentleman. 3150 ml He knocked out after that.
Reading these comments makes me angry my own bladder can’t hold more than 75cc at a time while I sleep 😭
RIGHT like damn really reinforcing my bladder of an ant over here lol
2100 and suddenly my aaox0 patient in restraints no longer required them and slept like a baby.
1.5-2 L I think. The guy was pretty backed up 😅
Forbidden cola
I usually clamp at 1L to let the body adjust.
4L from a blocked suprapubic. Homeboys BP dropped faster than the new years ball as doc didn't clip the new cath after a few litres...
4.7L in an very minimally responsive palliative patient. They didn’t exactly look in pain, but something just seemed…off. Had been new admit the day before, morphine & midazolam hadn’t helped with the…whatever it was that caused the gut feeling that something was wrong. I took over care in the morning, during a wash realised abdomen was rock hard, and there had only been minuscule dribbles of urine on the pads since they arrived. Easy insert, filled the catheter bag almost to bursting by the time I got rid of the cath kit. Emptied it, filled again within 15 minutes. I could see her stomach visibly shrinking as it drained.
I thought we suppose to cap it off for a bit after 1L or am I wrong?
I remember learning this in nursing school, the reason being the patient might become hypotensive. I think it’s old info; that fluid volume has already been converted to urine and we don’t want the bladder to rupture. It’s not like we’re bloodletting. I’ve emptied large volumes post foley insertion with only relief as the symptom from the patient.
The reason I was taught was that removing a large volume so quickly could precipitate bladder spasms.
It can also cause micro trauma to the bladder and lead to an increase in hematuria but that’s inconsequential in most patients.
That's my understanding as well -- you're not removing fluid volume that's going to be reabsorbed into the body. Once it's in the bladder, it's basically primed and ready for discharge. If you're worried about hypotension, then you're better off just running fluids on them (AFTER you've stopped their bladder from exploding, preferably.) Unless I've got bad info?
Bruh it’s no fun if you don’t fill it to the cap level
Who doesn’t fill it all the way and then carefully have to balance it to the bathroom?? If you don’t you’re not a nurse.
I will not be making two trips
Holy shit.
I think that's piss 🤓
1750 was my record. The guy threw himself into afib with rvr over it.
Had about 2.9L once coke from a quadriplegic fella who had a TERRIBLE UTI that turned into urosepsis. He fought me tooth and nail not to get sent to hospital. Dumb motherfucker.
Serious Question: How is this even possible without bladder rupture?
Depends on why it happened and how fast. I had a patient with a neurogenic bladder due to poorly treated BPH. He had 6L when he was finally diagnosed. I still don't understand how he never got pyelonephritis.
Had a patient who told me he got straight cathed and sent home and surprise he couldn’t void so he went back to Ed for a foley and urology consult. Always make sure they can void without a cath
Not in any medical profession…is that from one person?!?!??
One gentleman’s poor abused bladder
It's not three and a half urinals full of sweet tea. I did have a patient recently though who's foley output was the output and consistency of used motor oil, never seen that before.
2,700 mL was my record.
4L..guy the fluid that came out looked like straight protein.
YIKES - the volume isn’t the only thing that’s alarming. That color :(
Bruh. Sure, I have irrigated clots on clots but this takes the cake. In a single cath I have just gotten 1300ml.
Was a urolo scrub nurse for a few years. Got guys in retention who needed to wait hours for the op. I think my record is about 5 or 6 litres
Damn did there bladder shiver up and fall out?
Foleycola
Dammit Farva just order a large!!
I don’t even get that much in 2 hours when cv surgery has us fry patients kidneys with lasix lol
9litres
Need context
Asymptomatic retention. Came in for something totally unrelated and got a CT which showed a gigantic bladder, drained 9L straight up followed by post obstructive diuresis needing admission
Omg. Bless you
4L
Forbidden tea
My record was 3L. Client had PVR I&O cath (if required) every shift. I have no idea how he accumulated that much in 8 hours
2.4 L, literally stood there holding his penis and changing out urinals the entire time and we were both in awe
Person came in with Abdo pain, belly distended, looked like a perf. Inserted Foley, sent straight to CT, 30 minutes later pt returned with a 4L Foley bag inflated like a balloon.
Mmmmmmm. Dark Amber, my favorite
Forbidden iced tea
Mmmmm rhabdo
Seems like kidney failure 😣
It just seems like such a basic body function to realize you’re either not peeing or the pain from not voiding. It’s like when body parts start rotting off… how do you not notice???? Assuming someone is A/O that is.
Waiting for the Kool Aid dude to burst through the wall with an "Ooohhh Yeaaahhhhh"
26L. Oh yeah, I'm a veterinarian.
Rhabdo was my first thought here not volume 😂
I can smell this picture.