If a patient is experiencing issues with their Foley catheter, consider using POCUS.
Using a curvilinear probe over the suprapubic region, you can obtain a transverse view of the bladder by orienting the marker towards the patient’s right side, or a sagittal view by orienting the marker towards the patient’s head.
In a properly functioning Foley, the bladder will appear decompressed, and you may only see the Foley balloon.
In cases of obstruction or malposition, you may notice a distended bladder. The next step is to attempt to visualize the Foley balloon. If you do not see a Foley balloon within the bladder, try deflating the balloon and advancing the catheter.
If you notice debris blocking the foley or heterogenous material in a patient with hematuria, you can attempt to flush the catheter, but if the patient has a large amount of hematuria, you may need to replace the current Foley with a three-way catheter for continuous bladder irrigation.
References
Boivin Z, Li JJ, Gottlieb M, Liu RB. Troubleshooting Foley Catheter Problems using Point-of-Care Ultrasound, Journal of Emergency Medicine (2025). doi.org/10.1016/j.jemermed.2025.07.049
