The Murphy Drip was invented by John Benjamin Murphy as a way to infuse normal saline rectally for the treatment of peritonitis. My clinical experience with the Murphy Drip has been urethral for bladder irrigation. I’ve had quite a few of these patients recently, let’s see what all the fuss is about, shall we?
On my surgical floor, Murphy Drips are indicated for patients that have hematuria (bloody urine) that can be caused by a bladder mass, kidney stones, surgical procedures or any other injury to the genitourinary system. The Murphy Drip is a normal saline infusion via a three-way Foley catheter to irrigate the bladder and prevent clot formation that would occluded the urethra and make it impossible (and painful) for the patient to void their bladder.
In this first post, I am going to discuss the set up of the Murphy Drip and point out tips I’ve learned so that when you encounter one for the first time it won’t be completely foreign. If you do not work on a surgical floor or as part of a urology practice, it is unlikely you will run into the Murphy Drip.
What we will need:
- An IV pole
- 2L Normal Saline flush bags (order a box as needed)
- Normal saline (sterile) bottle for manual bladder irrigation
- Piston syringes (sterile, one time use per manual irrigation)
- Towels (just trust me)
- An I/O (input/output) record sheet
- A wash basin (labeled for irrigation only)
- A bedside tray table.
- Murphy Drip tubing (see badly drawn picture below)
There are four main elements to Murphy tubing.
- a + b are the spikes for the 2L normal saline bags
- a + b are the clamps for the tubing, have them both completely clamped before spiking
- The drip chamber, we need enough room to see how fast the drips are coming down
- Rolling titration clamp to start, slow down, speed up, or stop the infusion
We traditionally receive these urology patients to the floor already hooked up (i.e. Murphy drip to three-way Foley catheter). Our job is to monitor the drip, the patient’s comfort, and irrigate per physician order. The set up is as simple as that. We will also discuss managing the irrigation fluids, the patients, and the output in this series on Murphy Drips.
Up next, managing Murphy Drip fluids and patient.