Volumetric bladder ultrasound performed by trained nurses increases catheterization success in pediatric patients

• Published in: The American journal of emergency medicine 2008, Vol.26 (1), p.18-23
• Main Authors: Baumann, Brigitte M., MD, MSCE, McCans, Kathryn, MD, Stahmer, Sarah A., MD, Leonard, Mary B., MD, MSCE, Shults, Justine, PhD, Holmes, William C., MD, MSCE
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bladder; Caregivers; Child, Preschool; Children & youth; Emergency; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Emergency medical care; Emergency Nursing; Emergency Service, Hospital; Hospitals; Humans; Infant; Intensive care medicine; Intubation; Medical sciences; Methods; Nurses; Pediatrics; Ultrasonography; Urinary Bladder - diagnostic imaging; Urinary Catheterization - methods; Urinary Catheterization - nursing; Urine
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2007.03.020

Abstract Objective The objective of the study was to determine whether the use of volumetric ultrasound by trained pediatric emergency department (ED) nurses improves first-attempt urine collection success rates. Methods This randomized controlled trial was conducted in children aged ≤36 months requiring diagnostic urine samples. Children were randomized to either the conventional (nonimaged) or the ultrasound arm. Demographics, number of catheterizations required for success, postponements, and collection times were recorded. Results Forty-five children were assigned to the conventional and 48 to the ultrasound arm (n = 93). First-attempt success rates were higher in the ultrasound arm: 67% (conventional) vs 92% (ultrasound) ( P = .003). Both urinalysis and culture were less likely to be completed on conventional group specimens (91% vs 100%; P = .04). However, mean conventional group urine collection time was less than the ultrasound group's collection time (12 vs 28 minutes; P < .001). Conclusions Although there is a time delay, urine collection in the ultrasound arm generated a significant improvement over conventional catheterization in obtaining an adequate urine sample.