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)

I.

Bladder Volume Measurement

1.

Place patient in supine position. Don gloves. The most

accurate measurements are obtained when the patient
rests quietly in the supine position. Standard
Precautions.

2.

Turn the BladderScan instrument ON by pressing the

ON/OFF button.

3.

Press the SCAN button from the main menu screen.

4.

Then press the Gender button to select the appropriate

setting. The female setting excludes the uterus from the
measurement and should only be used for women who have
NOT had a hysterectomy. For all other patients, select
the "male" option. The LCD screen shows a male or female
figure to indicate the gender selected.

5.

Palpate the patient's symphysis pubis (pubic bone).

Apply a generous amount of ultrasonic gel to scanner
head.

6.

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, the head of the
icon will point toward the head of the patient. Place
the rounded end of the scanhead on the abdomen and aim
it toward the expected location of the bladder. For most
patients, this means angling the scanhead slightly
toward the patient's coccyx.

7.

Press and release the Scan button on the scanhead. Hold

the scanhead steady during the scan. When you hear a
beep, the scan is complete.

8.

Verify that the scanhead was aimed properly by using the

target-shaped Aiming icon, located on the right side of
the LCD screen. The light area represents the bladder
and indicates the position of the bladder relative to
the scanhead. The scan is accurate when the bladder
image is centered on the crosshairs of the aiming icon.
If the bladder image is not centered, re-aim the
scanhead and rescan the patient. To help you aim
properly, visualize ultrasound waves being projected out
of the scanhead toward the patient's body. If the
bladder is located on the left side of the icon, re-aim

the scanhead so that it projects ultrasound waves

further to the left.

II.

9.

When the scan is accurate, press the Done button to view

the Scan Results screen. Verify that the light colored
bladder image was completely contained in both the
vertical and horizontal scan planes. If the bladder
image overlaps the edge of one of the scan planes or
appears to be cut off, press the Scan button to return
to the Scanning screen. Then rescan your patient.

10.

When you have achieved an accurate measurement, press

the Print button twice to print the exam result.

11.

Documentation: Document assessment findings in patient

care notes.

Installing the Battery

1.

To remove the discharged battery, push the battery

release button located on the left side of the machine.
Batteries may require recharging every 3 days, depending
on use.

2.

Install fully charged battery into battery pack. Battery

icon indicates power status of the battery currently
installed in the instrument.

3.

Return the used battery into charger to properly

recharge the battery.
a.
A solid green light indicates fast charging mode
(2-3 hours).
b.
A quick blinking green light indicates the battery
has reached 80% of its charge level and the charger
"tops off" the charge. Battery recharger is located
?? (J2) Medication Room.
c.
The battery that is not in use is stored in the
charger so that it remains fully charged. There is
no danger of overcharging the battery.
d.
Fully charging the battery may take up to 6 hours.
e.
Plugging and unplugging the charger while batteries
are inserted causes no damage.

III. Installing Paper

1.
Open the paper well door at the top of the instrument.

IV.

2.

Insert the end of a new paper roll, with the thermal

side down into the paper input slot. The machine senses
the presence of the paper and feeds automatically. To
verify loading the paper with the thermal side down,
flick your nail over the paper. If a black mark appears,
this is the thermal side.

3.

Close the paper well door.

TROUBLESHOOTING
ALARM
1.
Inaccurate measurements or changes in performance.
a.
Assess aim, scanhead, ultrasound gel.
Increase gel
Scanhead motionless
Scanhead directed toward bladder (coccyx).
b.

Assess patient variables.

Patient supine, not moving, not talking, abdomen
not rigid
Assess for excessive amounts of body hair, abdomen
spasming, obesity
Reduce environment distractions, CPM off.
Increase amount of ultrasound gel.

c.

Verify accuracy with equation:

Pre-scan = Void + Post-Scan or PVR or SC
See Safety Features/Monthly Accuracy Check, below

d.

If inaccuracy validated, discontinue use and notify

your manager.

2.

Instrument does not turn ON.

Check battery icon in the upper-right corner of the LCD
screen.
If the battery icon is clear (empty), replace the
battery.

3.

BATTERY RECHARGE message.

Battery charge is too low to allow normal operation.
Replace battery with a charged one. The charger brings
the battery to a full charge in 6 hours or less.

4.

NO SCANHEAD message.
Scanhead is not connected. Reconnect scanhead to control
unit scanhead input socket.

5.

NO PAPER.
Printer is out of paper. Load new paper roll. Notify
your manager if there is no paper in the tray pocket.

6.

DISENGAGED PRINT HEAD.

Reposition the print head lever up as far as it can go.

7.

TOO HOT.
Print head is overheating. Turn machine off. Check for
paper jam.

8.

PAPER JAM.
Turn off instrument. Lower printhead release lever
(located adjacent to the paper advance thumb wheel).
Gently pull the paper backward, while moving the thumb
wheel counterclockwise. To avoid paper jams, never fold
the end of the paper, roll, or cut it diagonally or to a
point.

9.

CALIBRATION DUE
The instrument is calibrated yearly and the calibration
due date has passed. Press OK to continue. The machine
will continue to accurately scan measurements of bladder
volume. Notify your manager to arrange for calibration.

10.

Contact Precautions/Isolation
To create a barrier between the patient skin and the
scanhead
a.
Place gel on scanhead
b.
Apply a clean glove onto scanhead
c.
Apply gel over glove
d.
Continue procedure and scan

11.

Cleansing Instrument
Cleanse instrument with hospital approved disinfectant.

REFERENCES
BladderScan BVI 3000 Operator's Manual. 1998-2000.
Phillips, J. (2000). Integrating Bladder Ultrasound. AJN. March
2000. pp. 3-14.
Lehman & Owen. (2001). Bladder Scanner Accuracy During Everyday
Use on an Acute Rehabilitation Unit. Clinical Nursing 18(2), pp.
87-92.

Borrie, Campbell, Arcese, et al. (2001). Urinary Retention in

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