In this episode Justin introduces the importance of properly using urine output to monitor hemodynamics of both trauma and medical patients by interviewing 2 of our contributing working group members; Dr. Phil Mason Air Force Emergency Medicine Physician and Critical Care Intensivist and Dr. Chris Burns who is a Retired Navy Trauma Surgeon. Both of these doctors have been instrumental in answering the complex questions we have put forth because of their familiarity of our training and equipment available while also putting themselves out there in austere environments from time to time. Thank you both for taking your time to do this podcast.
Check out the show notes and handout below:
Measuring urine output via indwelling Foley Catheter has been called the poor man’s Pulmonary Artery Line which is an invasive diagnostic tool used to measure, among other things, the direct pressures inside the chambers of the heart which can help monitor resuscitation efforts. This field expedient tool is exactly what I need as a medic on the ground; a safe and effective way to monitor my patient using the tools I already have available. As medics we need to get over the stigma of sticking a tube in a guy and the process of keeping it sterile. It is an essential procedure, if done right, to see how your patient is doing. Until we get our own video from our PFC lab up on YouTube, there are plenty of other nursing students who have done this for us. Get familiar with this procedure before deploying or doing a PFC training scenario. Better yet train your junior or one of your other non-medical guys to do it.
A couple things mentioned in the podcast are worth reiterating here:
After insertion you may get a large amount of urine in the tube and bag.
Empty the tube into the bag and empty the bag into a graduated cylinder or a Nalgene you have previously marked down to the mL. What?! It’s sterile right?
This does not count toward hourly output!
Record the amount as your inital out and then flush it.
This is when the hour and your recording begin.
Set your watch or egg timer you included in your PFC kit for 60 minutes.
When the alarm goes off, empty the tube into the bag and the bag into the cylinder.
Record this number down to the cc, as your UOP on your documentation chart for trending.
You should be trending 0.5cc/kilo/hour or about 30-50cc per hour