• Rachel A O'Brian, Alexandru Firan, Michael J Sheridan, Maybelle Kou, Rick C Place, and Catherine H Chung.
• Department of Pediatrics, Duke University Medical Center, Durham, North Carolina; Department of Emergency Medicine, Inova Fairfax Hospital, Falls Church, Virginia.
• J Emerg Med. 2021 Sep 1; 61 (3): e32-e39.

BackgroundPediatric patients undergoing transabdominal pelvic ultrasound require a full bladder as an acoustic window. Patients are typically relied upon to subjectively identify bladder fullness, but inaccurate reporting often leads to delays in test results, diagnosis, and treatment.ObjectivesOur aim was to objectively evaluate bladder fullness by comparing the height of the bladder to the height of the uterus on point-of-care ultrasound (POCUS). Our hypothesis was that this method would result in faster time to imaging and decrease emergency department length of stay (ED LOS).MethodsBladder fullness was assessed using POCUS every 30 min until the bladder was full. If the height of the bladder was equal to or greater than the height of the uterus in the sagittal view, the bladder was considered full. The POCUS group was compared with a control group that relied solely on patients' self-identified bladder fullness.ResultsFemales aged 8-18 years old with pelvic pain in the pediatric ED were included in the study. Forty POCUS patients were compared with a control group of 105 patients. The POCUS group demonstrated a decrease in time to pelvic imaging by 38.7 min (95% confidence interval -59.2 to -18.2; p < 0.0001) and a decrease in LOS by 49.2 min (95% CI -89.7 to -8.61; p = 0.004). There was poor overall agreement on bladder fullness between patient's subjective sensation and POCUS (k = 0.04).ConclusionPOCUS to evaluate bladder fullness by comparing the height of the bladder with the height of the uterus reduces time to pelvic imaging and ED LOS.Copyright © 2021 Elsevier Ltd. All rights reserved.

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