Pediatric emergency medicine trisk 4506 4506
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FIGURE 131.19 Full bladder measured in two different planes.
Bladder Ultrasound
Bladder ultrasound is performed for a variety of reasons. For the child who has
not voided for a prolonged period, assessing bladder size can inform the
practitioner if there is a problem with urinary retention. More commonly, bladder
ultrasound is done prior to bladder catheterization or suprapubic aspiration to
assess volume of urine and thereby improve success rates. It may be used
dynamically as well to guide needle placement and improve success rates of
suprapubic aspiration.
Technique
The same approach as the pelvic view of the FAST examination is used when
performing a bladder ultrasound. A high-frequency linear probe or low-frequency
abdominal probe may be used. A full bladder will appear as a well-circumscribed,
fluid-filled (anechoic) structure within the pelvis. Once the bladder is identified, it
should be measured in at least two planes (Fig. 131.19 ). Although studies differ
with respect to exact measurements, generally speaking if the wall-to-wall
distance measures greater than 2 cm in both planes, catheterization or suprapubic
aspiration will likely be successful.
