BladderScan i10 IN-SERVICE Training Rev 01

BladderScan i10 In-Service Training The following pages provide an overview of the procedure for measuring a patient’s bladder volume using BladderScan i10TM. Recommendations • Please read the BladderScan i10 Operations and Maintenance Manual (OMM) carefully; it contains detailed information regarding the proper use of the instrument and instructions for performing a scan on a patient • Review the BladderScan i10 onboard tutorial to supplement the information in the OMM Important Points to Remember • BladderScan i10 features a live ultrasound image for pre-scan aiming. By default, this feature is enabled; it can be disabled in settings for the needs of your facility. • The BladderScan i10 system includes an onboard tutorial. It is recommended that you watch the tutorial prior to using the system. If you start the tutorial from the Home screen, the entire tutorial plays. If you start the tutorial from any other screen, the tutorial begins at the relevant section. • It is recommended that you use ultrasound gel (not any other form of gel) to ensure accurate results. Additionally, the use of adequate ultrasound gel is very important. Scanning with the wrong gel, or without enough gel is likely to result in inaccurate readings. Place an ample quantity of ultrasound gel (2-3 cm thick/20 grams), with as few air bubbles as possible, midline on the patient’s abdomen, approximately 3 cm (1 inch) above the pubic bone. Do not spread gel into a thin layer before scanning. • Target the bladder by aiming the probe, first toward the feet, then slowly toward the head to find the widest diameter of the bladder. Angle the probe slowly side to side to center the vertical green line on the bladder. Press and release the green scan button once, or tap SCAN on the screen. The scanning process begins. Hold the probe steady while the scan is in process. • After the scan is complete, a post scan result will appear on the touch screen display. If the post scan results indicate that the probe was not properly aimed (i.e., the bladder was not centered within the range of the ultrasound beam), re-aim and scan again as necessary. • If the screen displays a “greater than” symbol (>) next to the bladder volume measurement, then you do not have the bladder within full range of the probe and the patient’s true bladder volume may be greater than the volume displayed on the screen. • Press the print icon to print the largest volume measured during the exam. • Press SAVE and EXIT to end the exam and save the results.

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BladderScan i10 Has Simple Aiming Assist Features to Guide the User* Confirm or Adjust Aim

Aiming technique can have an impact on the bladder measurement result. When the bladder is partially outside the ultrasound field of view or obstructed by the pubic bone at certain scanning angles, then the actual bladder volume may exceed the displayed result. To help ensure the highest degree of accuracy, the system has several features to assist with aiming technique and confirmation. When the Results screen appears, check whether a yellow greater than (>) symbol appears next to the recorded volume and the bladder is shown in yellow. If this occurs, a portion of the bladder was outside the ultrasound field of view, and the actual bladder volume may exceed the displayed result. You should aim the probe again and rescan the patient. For guidance on how to improve the scan results, see below and reference the BladderScan i10TM Operations and Maintenance Manual. Figure 1. Greater Than (>) Symbol Displayed

Figure 2. Greater Than (>) Symbol Not Displayed

Bladder Measurement Accuracy RESULT

AIMING GUIDANCE

Successfully Centered

If the bladder is centered in the field of view, all bladder edges are visible, and there are no gray areas, then the scan was successful, and the results are optimized for accuracy.

Not Centered

If the bladder is not centered in the field of view, you may move or angle the probe in the direction of the bladder on the display to optimize your results.

EdgeScan

If one side of the bladder is not within the field of view, then a portion of the bladder was not included in the scan. The system displays a greater than symbol (>) before the measured result, indicating the actual bladder volume may exceed the displayed result. Move or angle the probe in the direction of the bladder on the display to optimize your results.

Bladder larger than view

If more than one side of the bladder is not within the field of view, then multiple portions of the bladder were not included in the scan. The system displays a greater than symbol (>) before the measured result, indicating the actual bladder volume may exceed the displayed result. You may attempt to capture the entire bladder by rescanning while applying less pressure to the abdomen. However, the bladder may be larger than the field of view, and it may not be possible to capture the entire bladder within the view.

Pubic bone interference

If a gray area appears, this indicates that the pubic bone is inside the field of view. Although the bladder may be centered and your measurement may be complete, there is a possibility the pubic bone is obscuring part of the bladder. The system displays a greater than symbol (>) before the measured result, indicating the actual bladder volume may exceed the displayed result. You may move or angle the probe to optimize your results.

*From the BladderScan i10 Operations and Maintenance Manual, available at verathon.com 3

EXAMPLE

BladderScan i10 In-Service Competency Quiz Name Unit

Date Evaluator

Objective The user will demonstrate the ability to accurately assess a patient’s bladder volume by obtaining an ultrasound measurement and printing a copy of exam results to attach to this form.* Competency will be demonstrated by viewing the onboard tutorial; obtaining an accurate bladder volume reading; and achieving a score of 80% or higher on this quiz. Mark the Following Statements True or False 1._____ The patient alignment icon on the probe and touch-screen display helps the user know if they are standing on the left or right side of the patient and to adjust orientation on the touch screen if necessary. 2._____ Moving the probe after pressing the scan button may result in inaccurate volume measurements. 3._____ A greater than symbol (>) along with a yellow post scan result indicates that the bladder boundary may be outside the scan area or partially obstructed by the pubic bone. Actual volume may be underestimated. 4._____ The bladder does not need to be centered in the scan plane for best results. 5._____ The post scan results are clinically acceptable if the color-coded bladder icon is green. 6._____ Urinary catheters, scar tissue, incisions, sutures, surgical staples, and fluid-filled cysts may all interfere with the accuracy of the BladderScan® instrument. 7._____ If the probe needs to be aimed further toward the feet, the user should tilt the probe so it points into the pelvic cavity (avoiding interference from the pubic bone). 8._____ You must hold down the scan button until the scan is complete. 9._____ The BladderScan instrument automatically saves the average bladder volume measurement from any series of scans.

*Printing is optional. 4

BladderScan i10 Competency Quiz (Answer Key) 1. The patient alignment icon on the probe and touch-screen display helps the user know if they are standing on the left or right side of the patient and to adjust orientation on the touch screen if necessary. TRUE

2. Moving the probe after pressing the scan button may result in inaccurate volume measurements. TRUE

3. A greater than symbol (>) along with a yellow post scan result indicates that the bladder boundary may be outside the scan area or partially obstructed by the pubic bone. Actual volume may be underestimated. TRUE

In most cases, the greater than symbol indicates that the probe was not properly aimed and the bladder was not fully within range of the BladderScan® instrument; thus, the bladder volume measured is lower than the true bladder volume, and the probe must be re-aimed and the scan repeated. If the bladder volume is greater than 999 mL, the measurement displayed is likely clinically relevant, but may not be within the expected accuracy range. 4. The bladder does not need to be centered in the scan plane for best results. FALSE

For best results, the probe must be properly aimed so that the bladder is centered within the scan plane. 5. The post scan results are clinically acceptable if the color-coded bladder icon is green. TRUE

6. Urinary catheters, scar tissue, incisions, sutures, surgical staples, and fluid-filled cysts may all interfere with the accuracy of the BladderScan instrument. TRUE

Urinary catheters, scar tissue, incisions, sutures, surgical staples, and fluid-filled cysts may interfere with the accuracy of the BladderScan, but in many cases, the BladderScan can still be used. These patients should be assessed on an individual basis. If possible, scan above, beside, or below potential sources of interference. 7. If the probe needs to be aimed further toward the feet, the user should tilt the probe so it points into the pelvic cavity (avoiding interference from the pubic bone). TRUE

8. You must hold down the scan button until the scan is complete. FALSE

It is not necessary to hold down the scan button during scanning; simply press and release the scan button to initiate the bladder volume measurement. 9. The BladderScan instrument automatically saves the average bladder volume measurement from any series of scans. FALSE

The BladderScan instrument automatically saves the largest bladder volume measurement from any series of scans.

Verathon Inc. 20001 North Creek Parkway Bothell, WA 98011 USA Tel: +1 800 331 2313 verathon.com

(USA & Canada only)

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Tel: +1 425 867 1348 Fax: +1 425 883 2896

BladderScan, the BladderScan symbol, BladderScan i10, Verathon, and the Verathon Torch symbol are trademarks of Verathon Inc. © 2021 Verathon Inc. Not all Verathon Inc. products and services shown are available for commercial sale in all countries.

Verathon Medical (Australia) Pty Limited Unit 9, 39 Herbert Street St Leonards NSW 2065 Australia Tel: 1800 613 603 (Within Australia) Fax: 1800 657 970 Tel: +61 2 9431 2000 (International) Fax: +61 2 9475 1201 0900-5093 Rev-01