Topics Discussed: drainage of bladder by indwelling suprapubic catheter; urology and nephrology.
Excerpt:"Indications. To obtain urine for culture when a less invasive technique is not possible. It is the most accurate and preferred culture source for infants when compared with urethra catheterization and bag urine specimens. Any bacteria or growth on a suprapubic culture is considered abnormal and requires treatment.
Equipment. Sterile gloves, povidone-iodine solution, a 23- or 25-gauge 1-in needle (a 21- to 22-gauge 11/2-in needle can be used in a larger infant) with a 3-mL syringe attached, 4 x 4 gauze pads, gloves, and a sterile container. Transillumination or ultrasound may also be used.
- Bladder aspiration is contraindicated in thrombocytopenia, bleeding disorders, cellulitis at the site, after recent lower abdominal or urologic surgery or if the bladder is empty.
- Verify that voiding has not occurred within the previous hour so there will be enough urine in the bladder to make collection worthwhile. Transillumination or ultrasound of the bladder can help determine the size and location of the bladder. Ultrasound significantly improves diagnostic yield; a minimum volume on ultrasound of 10 mL is associated with a 90% successful bladder aspiration. If the cephalocaudal diameter of the bladder (sagittal view) was >20 mm and the anteroposterior diameter was >15 mm, the..."
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