Bladder Scanning for Post Void Residual
Urinary incontinence can be an issue in Long Term Care facilities. Rehab and Post-Op are quite often dealing with incontinence issues. The ability to detect and classify the type of urinary incontinence as well as determine the best protocol is important to be able to address the incontinence. Industry estimates have incontinence effecting between 25% to 50% of residents in long term care facilities. The good news is more than 80% of urinary incontinent patients in long term care can be rehabbed in 45 days or less.
Most long term care facilities start with addressing any patient who has a voiding dysfunction. When a patient loses the sensation to void the resulting back pressure into the kidneys can cause significant health issues. Clinicians can palpate the bladder to determine if it is full and catheterize if a patient is not able to successfully void. Unfortunately this can lead to catheterizing patients that don’t need to be catheterized and missing patients that do need to be catheterized. A better method to estimate bladder volume scanner is to use a bladder scanner. Bladder scanners are quite prevalent and have become a “standard-of-care” for estimating bladder volume. The ability to easily see the bladder and, if required by the clinic’s protocol, make measurements on the image can prevent unnecessary catheterizations as well as certainty that a patient who does need to be catheterized will be identified.
Interson’s ViewBladder 10 is a tablet based bladder scanner. ViewBladder 10 is the most accurate and lowest cost bladder scanner available. Interson provides online introductions and online product training. You can find more information here – ViewBladder 10
Clinics need to develop and document their protocols as well as having documentation of training verification. The following two items can serve as a starting point to develop your clinic specific protocols and proper use guide, as well as your training checklist.
1. Be sure ViewBladder 10 was charged for at least an hour before use.
2. If necessary, remove the charging cable.
3. Start the tablet with the power button on the top right edge of the tablet – press the power button firmly for about half a second. Within three seconds the tablet should start powering up if was completely shut down or if only coming out of sleep will only take about one second.
4. For Post Void Residual, PVR, ask the patient to void. Note: you could choose to view and measure prior to the patient attempting to void and then view and measure after the patient tries to void.
5. Add a small amount of gel to the probe membrane – size of a jelly bean is typically the appropriate amount.
6. Position the probe on the patient’s midline – two finger widths above the pubic bone – with the blue button on the probe pointing to the patient’s right hip. Light pressure is all that is needed
7. Aim the probe to the patient’s rectum and then slowly tilt and tip the probe to obtain the largest image on the screen.
8. Freeze the image with the blue button on the probe or the yellow pause button on the tablet.
9. Measure the height and width of the bladder by holding and dragging your finger on the screen.
10. If void was successful, bladder image will be difficult to find and volume will be ~50 ccm to ~100 ccm.
11. If void was partial, volume will be ~150 ccm to ~250 ccm. If patient is only able to partial void for three days you may consider catheterizing to avoid a Urinary Tract Infection, UTI.
12. If bladder is near full ( ~350 ccm or greater) then patient should be catheterized.
13. Document bladder volume with date and time and whether or not the patient was catheterized in the patient chart.
14. Verify battery charge level and determine if tablet needs to be charged.
15. Put tablet to sleep by pressing power button for half a second. Be sure probe is NOT scanning when you put tablet to sleep.
Skills Checklist (you can copy, edit and put on your company letterhead / style sheet)
1. Connecting probe.
3. Imaging window.
4. Five control tabs.
2. Charging tablet.
3. Turning on tablet.
4. Putting tablet to sleep.
5. Playing Splash Video on startup.
6. Disabling Splash Video from automatically playing on startup.
7. Playing Splash Video at anytime.
8. Playing context sensitive Video Help.
9. Post Void Residual, PVR, procedure.
10. When to catheterize – what is our clinic’s protocol.
11. Palpate to find probe position on patient.
12. Gel.
13. Blue button to right hip.
14. Scan and then freeze when displayed image is optimal. (largest cross section of the bladder).
15. Measuring height and width.
16. Volume is displayed.
17. Record volume in patient’s chart.
18. Catheterize if residual volume meets clinic protocols.
Date / Time Clinician Name
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