Written by Megan Hilbert
Spoon Feed
The use of point-of-care ultrasound (POCUS) can decrease the chance of “dry tap” bladder catheterization on pediatric patients when looking for a source of infection.
It does matter, put that probe on the bladder
Urinary tract infections (UTIs) comprise approximately 7% of common serious bacterial infection in infants. There are especially high false-positive rates due to contamination with collection from urine bags, making urethral catheterization a gold standard part of diagnostic work-up. The most common cause of catheterization procedural failure is a “dry tap” on an empty bladder, which may be reduced with POCUS. This was a systematic review and meta-analysis of randomized controlled trials with primary outcome of first-attempt success rate. Secondary outcomes included total procedure duration, volume of urine, and adverse events.
Unsurprisingly, ultrasound-assisted bladder catheterization significantly increased first-attempt success: 146/166 (89.7%) vs. 124/171 (72.5%); RR 1.25, 95%CI (1.08–1.45, p-0.0022); and outperformed the blind method preventing “dry taps”: 6/166 (3.6%) vs. 41/171 (23.9%); RR 0.25, 95%CI (0.13–0.47, p<0.0001). The number needed to treat (NNT) for first-attempt success was 6, and NNT of 5 to prevent futile attempt.
How will this change my practice?
The results of this systematic review make sense to me; ultrasound can be a great adjunct to set us up for success in procedures, and this is no exception. I would highly recommend you try this on your next febrile non-toilet-trained child that needs bladder catheterization.
Source
Point-of-Care Ultrasound for Pediatric Urethral Catheterization: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Acad Emerg Med. 2026 Jun;33(6):e70342. doi: 10.1111/acem.70342. PMID: 42246462.
