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Information

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EBMG

Urine Aspiration Sampling in a Child

Indication

Equipment

  • 10 or 20 ml syringe
  • A thin injection needle
  • Cleansing equipment, bandages
  • Urine bacterial culture medium
  • Blood bacterial culture bottle

Procedure

  1. Lidocaine-prilocaine gel anaesthesia is recommended (the skin is anaesthesized in 30-45 minutes).
  2. The bladder should be as full as possible. In an acute situation, half-an-hour wait after urination at minimum is often enough. The child should drink during the wait.
  3. The child lies supine with the legs straigth, held by a safe and calm adult. Keep a sterile container available throughout the procedure for a "flying sample" in case the child begins to urinate.
  4. If an ultrasonography device is available, the doctor should check the filling and position of the bladder just before desinfecting the skin.
  5. The procedure is carried out using careful aseptic technique and sterile instruments. Desinfect the skin over the bladder with an antiseptic (e.g. 0.01% chlorhexidine solution).
  6. The puncture site is at the deep transverse fold visible above the pubic symphysis, or the site where ultrasonography indicates that the bladder is closest to the skin (in infants the bladder may be situated unexpectedly high). Insert the needle into the bladder quickly and perpendicularly to the skin and aspirate a sample (10-15 ml). If no urine is obtained, retract the needle slowly and aspirate gently. Sometimes a specimen is obtained at this stage.
  7. Remove the needle and cover the puncture site with a small dressing. If no sample was obtained try again after 30 min.
  8. Take both an ordinary urine culture sample, and inject urine into an aerobic blood bacterial culture bottle.
  9. If faeces is aspirated, withdraw the needle. An accidental bowel puncture does not cause complications, and no follow-up is necessary.