Although catheters have been the main method of surveillance when it comes to studying the bladder, they come with a very real drawback: CAUTIs, or catheter-associated urinary tract infections.
This was a common, painful, and costly problem among hospitalized patients. Therefore, a way to safely evaluate the need for catheterization was developed. This is called a bladder scanner.
As with all medical equipment, it’s important to understand proper use before attempting to operate it. This lessens the chance of error and misdiagnosis, not to mention saving valuable time. Read on for a guide on how to use a bladder scanner.
What Is a Bladder Scanner?
A bladder scanner is a hand-held, portable instrument that uses ultrasound imaging to perform a simple, non-invasive scan of the bladder. The computer in the device then receives the data and calculates urine volume. This gives the health practitioner an accurate idea of any necessary further steps.
Indications
Typically a bladder scanner is only used when there is an existing suspicion of bladder malfunction, particularly to do with urine retention. Keep in mind that simply because a patient is still urinating, doesn’t mean they aren’t retaining.
To determine if retention is happening and to what extent, scanning should occur immediately after the patient has relieved themselves. This is called inspecting their “post-void residual”.
Situations that may call for a bladder scan include but are not limited to the following:
- Assessing bladder retention
- Confirming catheter blockage
- Assessing bladder voiding capacity after a trial period following catheter removal
- Monitoring bladder function in patients with neurological disorders
- Suspected bladder dysfunction
- Recurring infection
Being able to properly empty the bladder is of utmost importance not only for bladder health but the health of the patient in general. Residual urine can cause bacteria to proliferate and urinary stones to manifest.
If urinary retention remains untreated for long periods of time and an infection is present, it can travel into the kidneys and possibly even lead to chronic kidney damage or failure. Learning how to use a bladder scanner can help prevent this from happening.
Contraindications
There are some instances where using a bladder scanner is either not recommended or would not be appropriate. These exclusions include a wound being present at the scanner probe site, pregnancy, and a patient’s lack of consent.
Required Supplies
Certain tools are necessary to ensure a proper scan and accurate exam results. Although different facilities may include more supplies as needed, the general ones are:
- Bladder scanner
- Ultrasound gel
- A skin-safe cleanser and wipe
- A sanitary wipe for the scanning device
- Apron
- Tissue
- Clean, disposable gloves
Even though ultrasound imaging is a non-invasive, low-risk procedure, hygienic safety protocols should be followed at all times. This is the responsibility of the conducting practitioner.
Before Scanning
There are a series of steps to follow before any medical exam, invasive or not. First, the procedure must be explained to the patient. Then informed consent may be obtained and documented.
Ask the patient if they would like someone to accompany them into the imaging room. If doing a post-void residual scan, ask the patient to use the restroom and measure the volume of voided urine.
Wash your hands, and put on appropriate gear such as disposable gloves and apron. Now you’re ready to operate the scanner.
Procedure: How to Use a Bladder Scanner
As is the case with learning any new skill, learning how to use a bladder scanner may seem complicated at first as you memorize the procedure. With practice, however, your confidence will grow and you’ll realize how simple it is. Here we’ve broken it down for you into an easy step-by-step guide.
Step 1
Turn on the scanner. Make sure the battery is charged and everything is in working order. You don’t want the device dying halfway through your procedure.
Step 2
Check (and double-check) to make sure you’ve selected the correct setting. The typical three are male, female, and child. Choose “child” if they are under 48 inches tall and weigh less than 60 lbs. If the patient is a female who has had a hysterectomy in the past, select “male”.
Step 3
Have the patient lay as flat as possible on the exam table or bed. Expose their lower abdomen and the area above their pubic bone, keeping privacy in mind. Place paper towel as necessary.
Step 4
After gently palpating their pubic symphysis (a secondary cartilaginous joint located in front of the bladder), squeeze a dollop of gel at least the size of a quarter directly onto the scanner probe head. Too much gel is better than too little.
Step 5
Usually shaped like a barcode scanner, grasp the probe by its handle and place the head on the skin about 3cm above the pubic symphysis. Position the probe on a downwards angle towards the bladder.
Step 6
Make sure you’ve aimed the probe correctly by adjusting it according to the target icon on the LCD screen. Typically you should be able to see a circle of urine on the monitor.
You’ll want to center it, if it isn’t already, by moving the probe into the proper position. Try tilting it towards the patient’s tailbone for a clearer reading.
Then, press and hold the button on the scanner head until there’s a beep and the reading is displayed. You’re literally taking a photograph, only with sound waves.
Step 7
Repeat step six several times with minor adjustments of the scanner head to make sure you’re seeing it from multiple angles. This ensures the most accurate reading, which is often the largest volume of urine scanned.
Step 8
Once you’ve gotten the most accurate reading possible, push the “done” button and either print or save, depending on the situational requirements. Sometimes you’ll do both.
After Scanning
After the procedure, remove excess ultrasound gel from the probe head and patient’s abdomen with a paper towel. Let them know that you’re finished, and give them time and privacy to get dressed.
If you’ve received the go-ahead from the patient’s doctor to discuss your findings with the patient, do so once they are dressed and comfortable. If not, inform the patient that the results will be with their doctor soon.
Remove disposable gloves and apron, wash your hands, clean the equipment according to the manufacturer’s instructions and your facility’s protocol, and either dispose of or replace all supplies.
Live By Prevention
It’s much easier to treat a bladder problem before it manifests as a full-blown chronic disease. This is why learning how to use a bladder scanner could seriously reduce the number of unnecessary invasive procedures and increase proactive treatment at your institution.
If you’re looking for a bladder scanning device of excellent quality and simple operation, check out our VioScan. We’re also happy to answer any questions you may have regarding all sorts of different medical equipment. Contact us today, we’d love to hear from you!