Contributor: Aaron Lessen, MD
Educational Pearls:
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Febrile work-ups in the emergency department require obtaining a urine sample to assess for UTI.
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In non-toilet trained children, this often means using catheterization.
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Depending on the volume of urine in the bladder, there may not be enough present to get an adequate sample.
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Performing a bladder scan before catheterization may be helpful in determining if there is enough urine there in the first place to get a sample.
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A recent systematic review and meta-analysis of three randomized control trials found that performing a POCUS prior to catheterization in 337 children aged 36 months and younger led to higher success in obtaining a sample.
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The success of getting a sample on the first attempt increased from 72.5% to 89.7%.
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The rate of dry taps decreased from 23.9% to 3.6%.
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POCUS before catheterization is an easy tool providers can use to ensure an adequate first attempt and reduce unnecessary discomfort for the child.
References:
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Vieira da Silva HF, Watanabe ET, Tavares MC, Ramos Bicalho AC, Ferraro LSD, Simões E Silva AC. Point-of-care ultrasound for pediatric urethral catheterization: a systematic review and meta-analysis of randomized controlled trials. Acad Emerg Med. 2026;33(6):e70342. doi:10.1111/acem.70342
Summarized by Ashley Lyons, OMS4 | Edited by Ashley Lyons & Ahmed Abdel-Hafiz, NREMT-P
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