Paediatrics: Suprapubic aspiration of urine

2021-04-15 01:33 PM

The optimal method for obtaining urine for bacteriology in a child <2yr old.

Suprapubic aspiration of urine

Optimal method for obtaining urine for bacteriology in a child <2yr old.

Equipment

  • 21–23G needle.
  • 2–5mL syringe.
  • An alcohol impregnated swab.
  • Sterile urine sample container.
  • Cotton wool or gauze swab and adhesive plaster.

Procedure

  • Wait at least 30min from last urination.
  • If in doubt as to whether the bladder contains adequate urine, perform bladder US to confirm.
  • Place child supine (with an assistant holding hips abducted) and then identify site—midline anterior lower abdominal wall 1cm above the pubic bone.
  • Clean site with an alcohol impregnated swab.
  • Insert needle connected to the syringe at 90° to the skin, aspirating continuously until urine is obtained.
  • Insert to almost the depth of the needle. If no urine is obtained, partially withdraw it before inserting again at different angle.
  • Once required urine is aspirated, remove the needle, press on puncture site with cotton wool or gauze swab, and then apply an adhesive plaster.
  • Place urine in sterile container.
  • If unsuccessful, repeat the procedure 30–60min later.