Rarely, a mild skin rash from the adhesive on the collection bag may develop. Acta Paediatrica; 96: 3, 432–436. McCollough M, Rose E. Genitourinary and renal tract disorders.
http://guidance.nice.org.uk/CG054. The alarm did not cut the likelihood of bacterial contamination. Use the soap, or cleansing wipes that your provider gave you. et al (1999) Is urethral catheterisation a successful alternative to suprapubic aspiration in neonates? Evaluation of the urologic patient; history, physical examination, and urinalysis. In these circumstances, NICE (2007) recommends the use of invasive methods such as suprapubic aspiration (SPA) or catheterisation. <>
Urine collection bags and urine collection pads canalso be used to collect urine. The samples obtained from the urine collection bag were found to be more sensitive to the dipstick test than catheter samples.
Urine collection bags and pads are more susceptible to contamination than the clean catch method, due to the close and prolonged contact with the skin around the anogenital area. endobj A health technology assessment (Whiting et al, 2006) suggests that: ‘The majority of studies included in the review found that clean voided midstream urine samples had similar accuracy to suprapubic aspiration (SPA) samples when cultured, with the advantage of being a non-invasive collection method that can be used in the GP’s surgery. In order to produce a meaningful laboratory test result, follow these instructions exactly. stream It is sometimes necessary to get a urine sample from a baby to do testing.
Large multi-centre trials will help to identify the best method but in the meantime we have to work within the evidence available.
This guideline recommends that all children presenting with unexplained fever of 38ºC or higher should have a urine sample tested for leukocyte esterase and nitrites after 24 hours.
In: Walls RM, Hockberger RS, Gausche-Hill M, eds. 9th ed.
Invasive technique was performed after CCU for three specific conditions.
A sample can also be collected at home.
Check the infant often, and change the bag after the infant has urinated.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. The criterion standard for obtaining urine specimens for culture in pediatric patients is suprapubic aspiration. Urine contamination rates were similar for sanitary pads and urine collection bags, and both were significantly higher than for clean catch (p. Urine pads tend to be recommended due to their cost-effectiveness, similar or lower contamination rate to urine collection bags and ease of use as well as parental preference (Rao et al, 2004; Lewis, 1998). Editorial team. Local anaesthetic cream was applied one hour before the SPA and the procedure was carried out by experienced medical staff. Invasive methods need to be considered when an infant is unwell and a sample of urine is required urgently for diagnostic purposes. Journal of Pediatrics; 147: 4, 451–456. In 2007 NICE produced a clinical guideline on the management of UTIs in children (NICE, 2007). A small catheter is inserted into the baby's bladder to collect the urine. If you collect the urine at home, have some extra collection bags available.
Pain was measured using a pain scoring tool.
Kozer, E. et al (2006) Pain in infants who are younger than two months during suprapubic aspiration and transurethral bladder catheterization: a randomized, controlled study. Paired urine collection bag and catheter specimens were obtained from each child and were tested with a urine testing stick and sent for microscopic urinalysis.
Sometimes, it may be necessary to obtain a sterile urine sample. (An active infant can cause the bag to move, so it may take more than one try to collect the sample.). The children attended a children’s hospital emergency department andhad been identified as being at risk of UTI. In: Rifai N, ed. If the opportunity exists to wait for a clean catch, this method continues to be reported as the gold standard and appears to have a consistent level of reliability comparable to the more invasive methods of urine sampling. Issues of consent must be discussed with parents as suprapubic aspiration can carry a risk, although complications are very rare (Barkemeyer, 1993). Archives of Disease in Childhood; 89: 8, 773–775. Authors: June Rogers, MSc, BA, RSCN, RN, is paediatric continence adviser, Liverpool PCT, Liverpool; Caroline Saunders, BSc, PGD, RSCN, RN, is consultant nurse urology/gynaecology, Royal Liverpool Children’s Hospital, Alder Hey, Liverpool. Ross, J.H. ��Up�'\�Ӳ�t��+0��\@T~.��Bl�9�@�f�Zژ�00,�Sp�=��F���CqqE�
Urinary tract infection (UTI) is the most common serious bacterial infection in infants and children and requires prompt diagnosis and treatment to reduce the risk of long-term problems(Dulczak and Kirk, 2005). There is no discomfort if the urine is collected using a bag. 's editorial policy editorial process and privacy policy. American Family Physician; 62: 8, 1777. NICE suggests urine collection pads as the next best option to clean catch. In infants younger than two months, suprapubic aspiration was more painful than transurethral catheterisation. You will be given a special bag to collect the urine. Rao, S. et al (2004) An improved urine collection pad method: a randomised clinical trial. i���wq���B��b�r��Mo�y��3tٶ��F���f��+E�2��XR���n���T2^��ͫ�_.�sj�z�a�m_�Ij���r!C����ziB��:�l�s!�i��Lg�v+RK.�hM����j�\�$�X{Z= ��`P[�o�l�C��۔�Nlx�͡ O�8!P8����_�� I������xN� A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. The guideline clearly states that manufacturers’ instructions regarding their use should always be followed and that cotton-wool balls, gauze and sanitary towels should not be used (NICE, 2007). Archives of Diseases of Childhood; 88: 9, 836. Young children in Western society generally do not achieve urinary continence until 2–3 years old, so other collection methods are required for precontinent children. is also a founding member of Hi-Ethics. The area around the urethra is cleaned with an antiseptic. ��������;ڶ�+�>.����d]$-�����t Pediatric Urine Collector Directions for Use: 1. follows rigorous standards of quality and accountability. An adequate urine sample was obtained in 18 (66%) of 27 patients in the suprapubic aspiration group and in 20 (83%) of 24 in the transurethral catheterisation group. In practice, both urine collection bags and pads have been used and there is a debate about which is more effective. There are no major risks to the infant. Abstract: Rogers, J., Saunders, C. (2008) Urine collection in infants and children. Urine collection bags and urine collection pads can also be used to collect urine.
A study by Rao et al (2003) explored whether the use of an enuresis wetting alarm, embedded in the pad, reduced contamination rates. Non-invasive methods involve waiting for spontaneous urine voiding, then opportunistic collection with a nappy pad, bag, or ‘clean catch’ of the urine stream. Pediatrics; 92: 3, 45.