Published Mar 7, 2012
pedspnp
583 Posts
AAP has published new guidelines for treating UTI's in ages 2 - 2-24 months I have just spoke with a former classmate from undergrad who really blasted this said to do caths was too traumatic in this age group, and there has too be a better way any input is appreciated
Presentation Febrile UTI 2011 Guidelines 2012 CB.pdf
LiLoRN
50 Posts
I'm aware of the guideline change. Sure, catheterizing an infant/toddler may be a horrible experience for all involved, but I'm confident that getting a reliable sample and being able to treat appropriately is more important than a few moments of discomfort. As you can see from the guidelines, "of all positive culture results for urine obtained in a bag, 85% would be false-positive results".
The nurses are complaining about it one has told me she won't do it. Well guess what it my license not hers. Even after I showed her the data and recommendations she replied it's only a guideline not written in stone
Bumashes, MSN, APRN, NP
477 Posts
I'm an RN in the ER, and I do these all the time. I don't LIKE doing them, but I definitely understand why my docs want them. Good for you for not wanting to load up kids on Abx for nothing.
rnsrgr8t
395 Posts
I work in peds urology and I applaud you for wanting to get an accurate speciman. That being said, I have a lot of peds practices that refer patients to us that do not cath in their office. If they have a febrile infant that needs a cath, they send them to our peds ER. If it is one of our established patients, I bring them to my clinic and I or one of our nurses do it. I do not know what kind of staff they have (nurses vs MA's) but they do not do it. I believe a bag speciman is pretty worthless especially in a child that is febrile and you worry about a UTI. We cath them all in my practice. If your nurses are not comfortable, maybe you can teach them?? From reading your previous posts though I have a feeling they are not interested. If you know what you are doing it is not that traumatic. Does your office have those infant cath kits with the speciman container attached to the catheter? We use those for the most part and they are great. Key is to have good holding help. I normally hae one of our MA's hold the legs and mom/dad hold hands and be at the head and talk/love on the babies. The guidlines are there for a reason and you are correct.