Bladder Management
During acute care of the child with severe TBI, it is common for a Foley catheter to be in place for measuring urine output. After the child has been transferred from the critical care unit to the rehabilitation unit, they typically are placed in diapers for management of their incontinence.
In children with cognitive impairment, the majority of their incontinence is a result of a disinhibited bladder. In these children, the bladder is emptied completely and bladder volume is reduced. If their cognitive status allows, they may be able to participate in a timed voiding program to achieve functional continence or to learn continence. Children may also have a neurogenic-type bladder with uninhibited bladder contractions, which can be treated with anticholinergic medication. This will allow for increasing bladder volume. If the clinician is faced with bladder emptying that resembles an upper motor neuron or lower motor neuron voiding pattern, it is imperative that spinal cord injury be ruled out. This possibility can usually be eliminated by demonstrating low postvoid residual volumes (183).
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More on the topic Bladder Management:
- EARLY TREATMENT
- TECHNICAL FACTORS OF NEEDLE ELECTROMYOGRAPHY
- AUTONOMiC DYSREFLEXiA
- UROLITHIASIS (BLADDER STONES)
- Management
- The Unit
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