blood from a stone

6 PEM papers that could change your practice – #6 – getting urine from neonates

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Simon Binks, an Emergency Medicine doc in Wollongong Hospital recently gave an awesome talk on six papers that changed his paediatric emergency medicine practice in the last year. This week we are posting one each day. You can hear the talk on Joe Lex’s Free Emergency Medicine Talks site.

See all the papers and discussion:

  1. The downsides of codeine in kids
  2. The outcomes of absorbable sutures in facial lacerations
  3. Abdo x-rays to rule out intussusception
  4. Bloods markers as predictors of serious bacterial infection
  5. High flow nasal cannulae for acute respiratory insufficiency
  6. Urine samples from neonates

Here I summarise the sixth paper he identified and his key points.

6.  Getting urine from babies is like getting blood from a stone

We have all spent time pondering over how long to wait for a urine sample and when to just do an in-out catheter or suprapubic aspiration.

A paper in Archives of Disease in Childhood looked at a new way of collecting urine in neonates.

Sounds great, what's the new way?

Give the baby a feed and then wait for 25 mins.

Get one other person to help you.

Hold the baby up (under the arms); tap on the bladder (100 taps per minutes) for 30 seconds; and massage the lower back for 30 seconds.

And they wee!

neonatal urine

Looks amazing.

Who were the patients?

This study looked at 89 patients. They were all neonates – with a mean age of six days.

And did it work?

86% voided within five minutes. The mean time to void was 57 seconds.

Worth a try? I’ve never used this but I intend to now. It would be interesting to know if it can  be applied to older infants.

References

Herreros Fernández ML, González Merino N, Tagarro García A, Pérez Seoane B, de la Serna Martínez M, Contreras Abad MT, García-Pose A. A new technique for fast and safe collection of urine in newborns. Arch Dis Child. 2013 Jan;98(1):27-9.

 

 

 

 

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About 

Tessa Davis is a paediatric emergency registrar from Glasgow and Sydney, but currently living in London. Tessa tries to spend time with her 3 kids in between shifts. @tessardavis | + Tessa Davis | Tessa's DFTB posts