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NEDERLAND EN BELGIË |
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donderdag 11 maart 2010
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Pediatrics
Pediatric units may require the evaluation of bladder volume status in cases of neonatal distress. The determination of a neonate's hydration status may also be an Indication for BladderScan® use. Older children may require bladder volume determination in instances of complaints of Overactive Bladder symptoms. The measurement of residual bladder volume not only is indicated in overactive bladder, but also in the evaluation of a child with a history of urinary tract infections.
Indications / Applications
Indications for the use of the BladderScan® at Pediatrics.
- Patient with a risk of urinary retention
- Patient with a risk of urinary residue
- Patient who hasn't been able to urinate spontaneously for some time
- At a patient after removing an indwelling catheter
- Patient with incontinency problems
- Patient who isn't been able to tell if he has to urinate
- Patient that is undergoing a bladder retraining program
Experiences of the nursing staff in practice
- The use of the BladderScan® eliminates unnecessary catheterization
- We are able to recognize urine retention in time
- The making of a measurement with the BladderScan® takes less time than a catheterization
- Less unnecessary use of disposables
- Always knowledge of the contents of the bladder
- Less deliberation about the necessity of catheterization
- Minimize risk of urinary tract infection and thus antibiotic use
- Use of the BladderScan® is more friendly to the patient than catheterization
- The BladderScan® contributes to the quality of care of the patient
Cost Analysis
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Key Clinical Messages
Padmore D. E. et.al . (1997 Canadian Journal of Urology Vol 4, pp. 1)
Evaluation of a non-invasive method to determine bladder volume in children
It was found that BladderScan is convenient and easy to use in children. It was better tolerated than urethral catherisations, and gave clinically acceptable measurements of bladder urine volumes.
Shah P. J. R. (2000 publication Verathon Medical)
Bladder Function in Children
This paper defines a formula for assessing the correct bladder volume in children and identifies that 50% of children with UTIs have bladder dysfunction. Assessment of bladder emptying after the implantation of an artificial sphincter for neuropathic incontinence showed 66% of patients had a significant residual volume
Massagli T. L. (1990 Developmental Medicine and Child Neurology, 32, pp.314)
Ultrasound measurement of urine volume of children with neurogenic bladder
The ultrasound scanner was found to be accurate, inexpensive and easy to use for measuring post-voiding residual urine volumes in children with neurogenic bladder
Massagli T. L. (1989 Journal of Urology Vol 142, pp. 989)
Experience with ultrasound equipment and measurement of urine volumes: Inter-user reliability and factors of patient position
Measurements made by an experienced examiner were compared to the true urine volume obtained by catheterisation. Correlation was highly significant. Accuracy and precision of the ultrasound measurements were not affected by patient position. Thus, little training is necessary to use this instrument, inter-user reliability is good, and accuracy and precision are clinically acceptable whether patients are in the seated or supine positions.
Murrey M. (1990 Journal of Paediatric Nursing, Vol 5, pp. 4)
Pediatric Application of the Bladder Volume Instrument
The reliability of a portable ultrasound scanner that automatically computes bladder volume and is battery-operated, has been studied and shown to be accurate. No significant technical training is necessary to operate it.
Munir V. et.al . (2002 Pediatric Emergency Care, Vol. 18, pp. 5)
Does the use of volumetric bladder ultrasound improve the succes rate of suprapubic aspiration of urine?
Ultrasound measurement prior to attempting suprapubic aspiration: 28 of 31 ( 90% ) had successful suprapubic aspiration when a minimum volume of 10 ml. was detected on ultrasound and no 0- 10 ml. readings were encountered. In phase two , the overall success rate of obtaining urine with the aid of the blaadder scanner was 31 of 39 subjects ( 79% ), compared with 16 of 36 subjects ( 44% ) without ultrasound. The volumetric bladder scanner is a rapid, safe, and accurate device that, in this study, greatly improved the success rate of suprapubic aspiration in small children. It also helped to avoid time delays or multiple blind attempts at suprapubic aspiration by predicting volumes at which suprapubic aspiration should or should not be attempted