Not completely emptying bladder with straight cath

[drue76]

Hi,

I have had a patiently recently that requires straight caths. I always bladder scan prior to see if parameters are met and often the number on the bladder scan is much higher than what I actually get when I straight cath. This is a male who had a pelvic fracture and now has a lot of hardware in that area, so I'm not sure that the bladder scan reads accurately. However, it has raised the question for me... could I be doing something wrong that I'm not emptying the bladder? Any tips or tricks folks have to offer when they straight cath to ensure they get everything out?

Thanks!

[Gooselady, BSN, RN]

Bladder scans can be 'off' due to obesity and altered anatomy, so if either are there I'd take the reading as not exact.

What about bladder scanning after catheterization?

Are the I&Os fairly equal?

I've applied firm but gentle pressure above the pubic bone when the bladder scanner reported much more urine than I get in the bag. His pelvic fracture would probably stop me from doing that at least until I had a better idea of just how messed up he is in there.

Gravity does it's bit to help empty the bladder too, but in a bed bound guy like this, you have gravity working against you.

[sandytoes]

The bladder scanner where I work is notoriously off. That's my first thought In your scenario. Sometimes when I am doing a straight cath, I do like pp said and massage the lower abdomen some. Also I will put the bed in a tilt (reverse trendelenburg) and that helps too!

[drue76]

Thanks for the replies. I've done some gentle pressure, but not much given the fx. I also put the head of the bed up and lower the legs to try and use gravity. In terms of I&O's, not terribly reliable, however when I was first working with the patient I was doing post cath scan and got 0. Over time I stopped doing the post cath scan, assuming it was just the bladder scanner that was off, especially since the patient was not showing signs of discomfort, etc after cathing and other nurses seemed to have similar experiences with this patient. I suppose I just started second guessing again! Thanks for the reassurance that bladder scanners are not necessarily accurate.

[CTnewgrad826]

We're suppose to bladder scan 3 times and take an average from that and even so the output isn't always in the same range. While bladder scans are awesome I've never worked with a consistently accurate one before