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FOR PERFORMANCE BY

:

RN, LPN

POLICY STATEMENT
The Ultrasound Bladder Scanner (BladderScan) will be used by RNs
and LPNs with documented competency to measure a reasonable
estimate of urinary bladder volume.
SUPPORTIVE DATA
The BVI 3000 computes the volume of the urinary bladder based upon
twelve, cross-sectional ultrasound images. For maximum accuracy,
the scanhead must be held motionless while scanning.
Indications for BladderScan include:
Patients with urinary retention
Monitoring urinary output
Verification of an empty bladder
Measurement of post-void residual (PVR) bladder volume
Verification that a Foley catheter is draining properly
Determination of need to catheterize following the discontinuation
of a Foley catheter or during an intermittent catheterization
schedule
Checking for bladder overdistention
Monitoring patients' hydration status
Urinary catheters, scar tissue, sutures, incisions, surgical
staples, bandages and fluid-filled cysts may interfere with the
accuracy of the BladderScan measurement. Patients should be
assessed on an individual basis and scanned beside, above or below
the suture/bandage to obtain an accurate measurement. Do not use
the BladderScan on patients with open skin or wounds in the
suprapubic region.
BladderScan is contraindicated for fetal use and pregnant
patients.
The device will reside on J2. Sign out the instrument when it is
removed from J2, and return to J2.
EQUIPMENT
BladderScan device
Ultrasound Gel
Alcohol wipe
PROCEDURE

Paper roll (Special order via manager)
Spare battery (Recharge in ?? J2)
Spare Ultrasound Gel tube (Distribution)

Turn the BladderScan instrument ON by pressing the ON/OFF button. re-aim . For all other patients. If the bladder image is not centered. 3. The most accurate measurements are obtained when the patient rests quietly in the supine position. If the bladder is located on the left side of the icon. When you hear a beep. Bladder Volume Measurement 1. 7. the scan is complete. Apply a generous amount of ultrasonic gel to scanner head. Then press the Gender button to select the appropriate setting. Palpate the patient's symphysis pubis (pubic bone). Verify that the scanhead was aimed properly by using the target-shaped Aiming icon. The LCD screen shows a male or female figure to indicate the gender selected. For most patients. Place patient in supine position. 8. Hold the scanhead steady during the scan. The light area represents the bladder and indicates the position of the bladder relative to the scanhead. located on the right side of the LCD screen. Locate the Patient Icon on the scanhead and make sure that when the scanhead is placed on the patient's abdomen 1 inch above symphysis pubis. 5. this means angling the scanhead slightly toward the patient's coccyx. The scan is accurate when the bladder image is centered on the crosshairs of the aiming icon. Place the rounded end of the scanhead on the abdomen and aim it toward the expected location of the bladder. 4.I. The female setting excludes the uterus from the measurement and should only be used for women who have NOT had a hysterectomy. 2. select the "male" option. visualize ultrasound waves being projected out of the scanhead toward the patient's body. Press the SCAN button from the main menu screen. To help you aim properly. Standard Precautions. the head of the icon will point toward the head of the patient. 6. Don gloves. re-aim the scanhead and rescan the patient. Press and release the Scan button on the scanhead.

Install fully charged battery into battery pack. 10. There is no danger of overcharging the battery. 2. A solid green light indicates fast charging mode (2-3 hours). e. Plugging and unplugging the charger while batteries are inserted causes no damage. Return the used battery into charger to properly recharge the battery. When the scan is accurate. The battery that is not in use is stored in the charger so that it remains fully charged. Then rescan your patient. press the Done button to view the Scan Results screen. Open the paper well door at the top of the instrument. press the Print button twice to print the exam result. 11. a. 9. press the Scan button to return to the Scanning screen. Battery recharger is located ?? (J2) Medication Room. depending on use. b. 3. If the bladder image overlaps the edge of one of the scan planes or appears to be cut off. A quick blinking green light indicates the battery has reached 80% of its charge level and the charger "tops off" the charge. Verify that the light colored bladder image was completely contained in both the vertical and horizontal scan planes. d. Fully charging the battery may take up to 6 hours. To remove the discharged battery. When you have achieved an accurate measurement. Battery icon indicates power status of the battery currently installed in the instrument. Documentation: Document assessment findings in patient care notes. Installing the Battery 1. . c. Batteries may require recharging every 3 days. II. push the battery release button located on the left side of the machine. Installing Paper 1.the scanhead so that it projects ultrasound waves further to the left. III.

Close the paper well door. replace the battery. Verify accuracy with equation: Pre-scan = Void + Post-Scan or PVR or SC See Safety Features/Monthly Accuracy Check. Inaccurate measurements or changes in performance. If inaccuracy validated. Replace battery with a charged one. Instrument does not turn ON. Scanhead is not connected. The charger brings the battery to a full charge in 6 hours or less. c. Battery charge is too low to allow normal operation. not moving. Assess aim. Insert the end of a new paper roll. If the battery icon is clear (empty). obesity Reduce environment distractions. NO SCANHEAD message. this is the thermal side. BATTERY RECHARGE message. 3. To verify loading the paper with the thermal side down. If a black mark appears. Reconnect scanhead to control unit scanhead input socket. discontinue use and notify your manager. 3. Check battery icon in the upper-right corner of the LCD screen. flick your nail over the paper. 4. Increase amount of ultrasound gel. Increase gel Scanhead motionless Scanhead directed toward bladder (coccyx). with the thermal side down into the paper input slot. b. abdomen not rigid Assess for excessive amounts of body hair. a. 2. Patient supine.IV. CPM off. abdomen spasming. 2. not talking. below d. TROUBLESHOOTING ALARM 1. . ultrasound gel. The machine senses the presence of the paper and feeds automatically. scanhead. Assess patient variables.

Printer is out of paper. while moving the thumb wheel counterclockwise. AJN. Integrating Bladder Ultrasound. Apply gel over glove d. Phillips. 87-92. TOO HOT. Bladder Scanner Accuracy During Everyday Use on an Acute Rehabilitation Unit. 1998-2000. 8. DISENGAGED PRINT HEAD. or cut it diagonally or to a point. Load new paper roll. 9. Continue procedure and scan 11. pp. 7. J. NO PAPER. PAPER JAM. Gently pull the paper backward. CALIBRATION DUE The instrument is calibrated yearly and the calibration due date has passed. roll. Check for paper jam. Apply a clean glove onto scanhead c. never fold the end of the paper. 10. The machine will continue to accurately scan measurements of bladder volume. To avoid paper jams. 3-14. REFERENCES BladderScan BVI 3000 Operator's Manual. Turn machine off. pp. Print head is overheating. Turn off instrument. Notify your manager if there is no paper in the tray pocket. Place gel on scanhead b. Contact Precautions/Isolation To create a barrier between the patient skin and the scanhead a. 6. . Press OK to continue.5. Lower printhead release lever (located adjacent to the paper advance thumb wheel). Cleansing Instrument Cleanse instrument with hospital approved disinfectant. (2000). Clinical Nursing 18(2). Lehman & Owen. (2001). Reposition the print head lever up as far as it can go. March 2000. Notify your manager to arrange for calibration.

Arcese. Risk Factors. Policy will be reviewed every three years C. 26(5). et al. Campbell. Policy stored in P/P: Nursing. 187-191. Previous versions of policy are stored in Retired Med Surg . (2001). STORAGE. Patient Care B. RETENTION AND DESTRUCTION A. Urinary Retention in Patients in a Geriatric Rehabilitation Unit: Prevalence. pp. and Validity of Bladder Scan Evaluation Rehabilitation Nursing.Borrie.