Bladder Scans

locolorenzo22, BSN, RN · Apr 9, 2008

it's not an exact science...but of course, remembering that your female patients with hysterctomies show up as men on the bladder scan.....I usually just hunt lightly, until I find the urine starting to show up, then I push in a little deeper, and always warn that it may hurt a little....I once did it light(when I first started) and got 400ml....then my co-worker (of 18 years) did it and got over 1000! real number....about 850....so it depends...but I find it's usually more than what shows up....

TiredMD · Apr 10, 2008

1) Make sure you have the correct gender entered into the machine.

2) Make sure the probe has the arrow pointing in the correct direction.

3) Find the pubic symphysis, use liberal amounts of ultrasound gel, and place the probe just superior to it.

4) Push the button.

5) If you have the graphic display, make sure the that the crosshairs are centered over the picture of the bladder. Adjust as needed.

6) Repeat once or twice to ensure that you are getting a reproducible reading.

7) Recognize that individual machines have effective ranges above and below which the machine will not give accurate volumes. Find out what these are, so you don't stress about whether it is 2L or 3L for no good reason.

8) When in doubt, walk away and try again in an hour to make sure your numbers are making sense.

ChristineN, BSN, RN · Apr 10, 2008

7) Recognize that individual machines have effective ranges above and below which the machine will not give accurate volumes. Find out what these are, so you don't stress about whether it is 2L or 3L for no good reason.
.

Excellent advice. I just wanted to comment that the bladder scanners I've worked with only go up to 1 Liter (and yes, I've then straight cathed them for closer to 2).

Elvish, BSN, DNP, RN, NP · Apr 10, 2008

I do NOT have good luck with bladder scans, but Tired has some excellent points.

Ms Kylee · Apr 10, 2008

And always remember.. the straight cath bags are not correct... they're usually off by 150 ml or so. I scanned a patient for just over 600 once, and the cath bag was reading 1000 ml... I emptied it into a graduate and got 850.

I usually try to scan all 4 quadrants and take an average. Generally, we have orders to straight cath if between 300-450 ml on the scanner.

miko014 · Apr 10, 2008

And always remember.. the straight cath bags are not correct... they're usually off by 150 ml or so. I scanned a patient for just over 600 once, and the cath bag was reading 1000 ml... I emptied it into a graduate and got 850.

Valid point, but why would there be a bag on a straight cath? It should just be a cath that goes in and then right back out, so no need for a bag. Every kit I have ever seen has had a cath, the cleaning supplies, a container for a urine sample, and a plastic bucket.

sfsn · Apr 10, 2008

Valid point, but why would there be a bag on a straight cath? It should just be a cath that goes in and then right back out, so no need for a bag. Every kit I have ever seen has had a cath, the cleaning supplies, a container for a urine sample, and a plastic bucket.

Kits vary. The straight cath kit we use for males has a red rubber cath that is attached to a bag, along w/ betadine swabs, lube, and sterile gloves.

UM Review RN, ASN, RN · Apr 10, 2008

I usually take several readings, the way TiredMD explained. The reason I do this is that I usually take care of elders and their bladders seem a little floppy. That is, if an elder patient was lying on one side before the scan, it seems that that side of the bladder will generate a higher reading even though I've repositioned the patient to her back for the scan.

I also slightly tilt the point of the scanner toward the pubis, no matter where I'm scanning from on the abdomen.

Ms Kylee · Apr 10, 2008

Our kits have a pad, a drape, cotton balls, tweezers, betadine, lube, and a bag attached to the tube. There is also a container for urine if a sterile specimen is needed. Our kits do not have a plastic bucket.