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The bladder scanner is a key instrument in acute patient care that provides medical and nursing staff with accurate bladder volume readings. The results of a bladder scan can help doctors diagnose a number of issues involving the bladder such as urinary retention, renal deficiency, large post void residual, urinary tract infection or benign prostatic hyperplasia (BPH).
The scanner uses an ultrasound probe and transducer to reflect sound waves from a patient's bladder to the scanner. The data from the handheld probe is automatically transmitted to the computer to calculate the patient’s bladder volume. The bladder scanner is a mobile unit and can easily be moved to a patient’s bedside. The scanning process is quick and only takes a couple of minutes to complete.
Using a bladder scanner is a safer and faster way compared to inserting a catheter. Unnecessary catheterisations are unpleasant for the patient and can cause complications such as infections.
Bladder scanning machines have three patient settings which affect how the machine calculates the amount of fluid in the bladder. These are adult with a uterus, adult without a uterus and child. They also feature a range of ways to chart the exam results. Some machines may display the exam results as a barcode that can be scanned by the attending doctor from an external monitor, a printed hard copy, or exported via USB.
A bladder scanner relies on ultrasound waves to gather data during a scan. However, ultrasound waves have a difficult time travelling through air. For this reason, a thick ultrasound gel should be used to reduce air gaps between the patient's skin and the ultrasound probe.
It is important to apply an ample amount of gel to the skin and the probe tip. Most of the time a 20g packet should be enough gel for most patients. The gel should be applied in a thick mound on the abdominal area approximately the size and shape of a golf ball.
Reaiming the probe or the patient moving may cause the gel to spread out during the exam and introduce air gaps. In this case, more gel should be added.
Once a scan is complete the probe should be placed on the dock while the ultrasound gel is cleaned from the patient. The probe should then be disinfected and set to air dry. The probe cable, console and workstation surfaces should also be cleaned. Furthermore, the probe should be wiped with alcohol disinfectant wipes between patients.
Most bladder scanners are compatible with a range of hospital cleaners and disinfectants, however, the maintenance manual should be checked for a complete list of approved cleaning chemicals.
Bladder scanners are simple machines to operate. Ultrasound gel should be applied generously so that the tip of the probe is completely surrounded on all sides. The placement of the transmitter should be slightly above the pubic bone along the midline.
The fluid in the bladder will appear black and should be aligned in the center of the monitor screen. Optimise the angle of the probe by tilting the tip towards the patient's head or feet to find the largest bladder outline. Once positioned correctly press the scan button. The scanning process takes a few seconds and will cause slight vibrations. Hold the probe still until the probe is complete. Then, review the scan to ensure an accurate reading has been recorded.
When using a bladder scanner there are some common errors that operators might make. These include, but are not limited to:
Applying too much or too little pressure. Typically a gentle amount of pressure should be used with the probe. However age, body mass, abdominal distension and individual anatomy can influence the size and location of the bladder. When scanning high BMI patients, the bladder is located deeper within the body and additional pressure may be required. On the other hand, when scanning a slim adult or child, the operator may need to reduce pressure to ensure that the bladder is not displaced beyond the measurable margins of the machine.
Wrapping the chord of the probe around your arm or hand. It is important for the operator to ensure the chord is tangle free and should follow along the length of the arm.
Scanning a section of the pubic bone. If the scan reveals a section of the pubic bone was included it should be redone. This may have affected the probes calculation and will most likely be inaccurate. The scan should be conducted along the midline to prevent this.
Bladder scanners range in price from $3,400 - $11,000. The price of the unit will depend on the available features provided by the manufacturer. Top of the line scanners provide detailed 3d imaging that help the operator easily position the probe for the best results possible. Other features such as the scanner being mounted on a trolley allow the machine to be moved and positioned with ease. Spare batteries are also available to prevent machine downtime.
A bladder scan is a non-invasive way to check the volume of a patient’s bladder. Most machines have a consistent scan accuracy of ± 6% on volumes greater than 100 mL and ± 6 mL for volumes less than 100 mL. This is across all patients including gender, age, weight and anatomies.