Epistaxis: Nasal Packs And Foley Catheters
Rahul Jandial, Danielle D. Jandial in Code Blue, 2014
This chapter provides information on the placement of nasal packs and foley catheters. It begins with a case scenario of a 24-year-old man with a known vascular nasal tumor, who’s presents with unrelenting nasal bleeding. The chapter then includes details on indications, contraindications, and information about supplies and technique. Pearls and pitfalls are also incorporated, providing additional insights and practical advice not always available in other textbooks or articles." Patients with Foley catheters in place for epistaxis should be admitted to the hospital and receive antibiotics. 24-year-old man with a known vascular nasal tumor presents with unrelenting nasal bleeding. If infection is suspected, the nasal packs must be removed.
Distal colostogram: Technical points
Victoria A. Lane, Richard J. Wood, Carlos A. Reck-Burneo, Marc A. Levitt in Pediatric Colorectal and Pelvic Surgery, 2017
This chapter explains the key principles in the management of complex pediatric colorectal diagnoses. It provides case-based presentations, radiographic images, operative images with Multiple Choice Questions to test knowledge. The chapter presents an overview of distal colostogram. The high-pressure colostogram is the most important radiologic examination to demonstrate the specific type of fistula, length of mucous fistula, the anatomic relationship of the fistula to the sacrum/coccyx, and the distance of the rectum to the expected position of the anus. Prior to beginning the procedure, the expected normal position of the anus is delineated with a radiopaque marker and a radiopaque ruler is placed under the patient for accurate measurements. A Foley catheter is inserted into the mucous fistula. Hand injection of an initial contrast bolus defines the length and relative diameter of the mucous fistula. The catheter is repositioned into a segment that is amenable to Foley balloon inflation, without the risk of perforation.
Epistaxis
S Asbury, A Mishra, KM Mokbel, M Fishman Jonathan in Principles of Operative Surgery, 2017
Although in most cases epistaxis is self-limiting, this can be a life-threatening condition. Management would involve the following steps. First, assess the patient while attempting digital control of the bleeding, second, identify the source of the bleeding and finally stop further haemorrhage. Around 80% of cases of epistaxis arise from Kiesselbach’s plexus of vessels in Little’s area of the anterior portion of the septum. The patient should attempt to clear their nose of blood by blowing their nose. A balloon catheter can also be used for tamponade in posterior epistaxis. A Foley catheter is inserted into the nostril until the tip is seen in the posterior pharynx. The balloon is then partially inflated with water and pulled back to sit firmly against the posterior choanae and secured in place. Pressure on the alae or columella should be avoided to prevent possible necrosis.
Foley catheter for induction of labour: a UK observational study
Published in Journal of Obstetrics and Gynaecology, 2020
Elizabeth Stephenson, Aditya Borakati, Ian Simpson, Padma Eedarapalli
We conducted a prospective observational study of all inductions using Foley’s catheter at our center between 2016 and 2018. Outcome data collected included induction to delivery time, mode of delivery, complication rates, patient and staff satisfaction. Ninety-nine women were included in our study. Median induction to delivery time was 28.3 h (IQR 19.7–34 h), 20 (20.2%) women required Caesarean section. No relevant complications were recorded. Patients and staff were satisfied with the technique overall. These results show transcervical Foley’s catheter is a safe and effective method of induction of labour in the UK setting. It was shown to be feasible in the outpatient and previous Caesarean section groups.Impact statementWhat is already known on the subject? Foley catheter as an induction agent has already been shown to be as clinically effective as slow release prostaglandins with lower costs.What do the results of this study add? No study has been published on its use for routine inductions in the UK. Our results show that Foley’s catheter is a safe, effective method for inducing labour in the UK.What are the implications of these findings for clinical practice and/or further research? This suggests this technique should be implemented more widely in the UK.
Effect of the Foley catheter and synchronous low dose misoprostol administration on cervical ripening: A randomised controlled trial
Published in Journal of Obstetrics and Gynaecology, 2013
E. O. Ugwu, H. E. Onah, S. N. Obi, C. C. Dim, O. A. Okezie, C. O. Chigbu, O. S. Okoro
This randomised controlled trial was carried out over a 14-month period in a tertiary health institution in Nigeria, to determine the effectiveness of Foley catheter and synchronous low dose misoprostol for pre-labour cervical ripening. Term pregnant women with unfavourable cervices (Bishop's score < 6) requiring cervical ripening/induction of labour were assigned randomly into three groups: Group A, transcervical Foley catheter was used synchronously with low dose intravaginal misoprostol; Group B, transcervical Foley catheter alone was used and Group C, low dose intravaginal misoprostol alone was used. The time to achieve a favourable cervical status as well as vaginal delivery was significantly shorter in the synchronous group than in the control groups (p < 0.05). The synchronous use of Foley catheter and misoprostol is very effective in cervical ripening and should be considered in clinical situations where there is need to hasten vaginal delivery in the presence of an unripe cervix.
Foley catheter versus intravaginal prostaglandins E2 for cervical ripening in women at term with an unfavorable cervix: a randomized controlled trial
Published in The Journal of Maternal-Fetal & Neonatal Medicine, 2018
Giulia Barda, Hadas Ganer Herman, Ron Sagiv, Jacob Bar
Objective: The objective of this study is to compare the efficacy of labor induction by Foley catheter balloon (FCB) insertion to intravaginal dinoprostone tablet placement in women with an unfavorable cervix. Materials and methods: A prospective randomized controlled trial was conducted. Women were assigned to insertion of a FCB or placement of a vaginal dinoprostone tablets and their outcome were compared. Results: The study comprised 300 women. The time to active labor was significantly shorter in the FCB compared with the dinoprostone group, but required more oxytocin administration. A lower rate of cesarean section was found only in nulliparous women in the FCB group. The neonatal outcome was favorable and similar in both groups. Conclusion: Both methods had similar results regarding achieving vaginal delivery within 24 h and cesarean section rate. For nulliparous women, the FCB induction method had the advantage of a shorter time to active labor and a lower rate of cesarean section.