Bladder Aspiration

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SAMPLE EXCERPT
- Full procedure text, video and illustrations available with the full product
PRE-PROCEDURE
INDICATIONS
  • Collection of a sterile urine specimen
  • Temporary relief of acute urinary retention
CONTRAINDICATIONS
  • Anticoagulated patient or patient with coagulopathy
  • An uncooperative patient
  • Infection or cellulitis of the suprapubic area
  • Full bladder not palpable*
  • Patient who cannot lie supine or have the bladder palpated*
  • Surgical scars or bladder or pelvic anatomic abnormality*
  • Abnormalities of genitourinary or gastrointestinal anatomy*

*May be possible with ultrasonic guidance.

EQUIPMENT
  • Local anesthetic: 10 mL lidocaine 1%
  • Needles:
    • For anesthetic: 1½-inch, 25- to 30-gauge needle
    • Localization: 4-inch, 22-gauge spinal needle
    • Aspiration: Use the localization needle or an 18- or 20-gauge intravenous needle.
  • 10-mL syringe
  • Microscope slide for direct examination, methylene blue, and Gram stain
  • Sterile urine culture collection container
ANATOMY
  • The bladder sits just posterior to the pubic symphysis. In the female, it lies just inferior to the uterus.
    • The colon lies posterior and inferior to the bladder.
    • The common iliac and hypogastric vessels lie beside the bladder.
  • Abdominal wall anatomy
    • The epigastric arteries and veins lie adjacent to and run parallel with the linea alba.

PROCEDURE
Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

POST-PROCEDURE
CARE
  • Advise the patient to expect possible discomfort or soreness in the area for a day or so.
  • Advise the patient to notify the clinician if there is persistent or increasing hematuria, abdominal pain, difficulty urinating, or a temperature above 101°F.
COMPLICATIONS
  • Transient hematuria
  • Perivesical hematoma
  • Intestinal perforation
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