Slide 1

BioCon bladder scanners
Frequently asked questions

Covers the BioCon-700, BioCon-900, BioCon-900S and BioCon-1100.

Includes questions relating to contraindications, settings, interpreting results and more.

Yes. You can undertake a self-diagnostic test. This is purely a functional test to undertake, for example, if you have dropped your scanner or probe. This is not calibrating your device. Calibration is undertaken by engineers and is a separate test altogether. Older software may not have this feature (upgrades are available).
BioCon-700  ‘Settings’ – ‘General’ – ‘Self-diagnostic’ – ‘Scan’
BioCon-900 ‘Settings’ – ‘General’ – ‘Self-diagnostic’ – ‘Scan’
BioCon-900S & BioCon-1100 ‘Maintenance’ – ‘Self-diagnostic test’. If activated, it may be password protected. PIN protection (if active) can be deactivated or changed – refer to the EBME department or contact de Smit Medical or refer to the operator manual for instructions.
BioCon-700 pre-Oct 2020 BioCon-700 post-Oct 2020  PIN protected can be provided as an upgrade (POA) PIN protection is provided as standard (activated under setup)
BioCon-900 Not PIN protected
BioCon-900S & BioCon-1100 PIN protected if desired (under setup)
Yes. All BioCon bladder scanners use HL7 (EPR compatible language) to enable you to connect to the NHS EPR system.
BioCon-700 & 1100 No. The probe and scanner are calibrated together and become a matched pair. Recalibration is required if the probe is swapped. BioCon-900 & 900S NA
The BioCon bladder scanner barcode label identifies the make, model, and serial number (barcode formatted to GS1-128).
BioCon-700 Not able to read a patient barcode.
BioCon-900 & 900S Barcode reader – patient ID & user ID function available – optional at point of order.
BioCon-1100 Barcode reader – patient ID & user ID function available – can be added at any time.
For a comprehensive guide on all BioCon bladder scanners, please contact de Smit Medical.
Yes. The BioCon-1100 has a Wi-Fi (CUBEFi) connection from the bladder scanner to the nominated PC using CubePro software to download onto your NHS EPR system. Contact de Smit Medical for more information.
BioCon-700 Internal storage +40 records (depending upon voice annotation used) 4GB external (SD card) – 1400 records
BioCon-900/900S Internal storage only – 50 patient records
BioCon-1100 Internal storage only – 1000 patient records
 
Yes. See the results from a study entitled: ‘Reliability of an automatic ultrasound system in the post-partum period in measuring urinary retention’ by Van Os AF, Van Der Linden P. 2006 (https://www.ncbi.nlm.nih.gov/pubmed/16752241). Results: ten additional catheterisations were performed by using bladder scanner, when compared with the number of estimated catheterisations based on clinical indications. Eight women had a residual volume of more than 300ml, of whom two had an indwelling catheter. Using Bland-Altman methods, there was no significant difference in volumes measured by bladder scanner or by catheterisation. Also, there was no significant difference between two observers.
Yes. However, remember the bladder scanner picks up all fluid so it will also read the volume of saline within the balloon. Deduct this from your reading.
This is not common but can sometimes happen. If it says there is fluid within the abdomen, trust your scanner. Example: the bladder scanner says PVR 400ml, you decide to catheterise, then only mange to drain off 100ml. Scan again after catheterising, you should have approx. 300ml remaining, however you now know that this fluid is not in the bladder. It could be identifying, for example, cyst/bladder diverticulum/ascites/fluid mass. This warrants further investigations to determine what this accumulation of fluid is.
Typically:                        Small pink cross indicates small bladder Large pink cross indicates larger bladder Often, when you see a small pink cross, indicating very small volumes, you do not get a good view of the bladder and sometimes the pink cross disappears (small bladders will sit behind bowels/organs so you cannot always get a good clear image). In this instance, aim the probe (rays) towards the patient’s feet, and press ‘scan’. If it can see anything, it will give a reading, even if you cannot see the bladder clearly yourself. Bladder volumes of <50ml are not always easy to see or find. If after several attempts you are getting 0ml readings, and you are aiming it in the general direction of the bladder, you can be satisfied that there is very little fluid remaining in the bladder. Have the patient drink, and re-scan in >10minutes. Typically, the adult kidneys will produce approximately 1-2ml/minute (dehydrated patient) or more.
BladderPoint™ with its auto correction tool will ensure that even if your bladder is not centred within the crosshairs, it will still be an accurate scan as long as the whole bladder is captured within the crosshairs, it will be measured. Example:
It will take 4-6 hours to charge the battery to its optimum level, depending on the model. In the unlikely event that the battery is flat, it should be charged for approximately 10 minutes before the scanner is operational again. It is recommended that the scanner is placed on charge before the charge level indicator reaches one bar.
No. The frequency settings on the BioCon scanner does not allow you to see any anatomical detail, including seeing the catheter balloon. This is to ensure simplicity of use for all. The pre-set frequency means that the BioCon scanner can only read fluid. That includes the saline within the balloon (10-20ml, depending upon catheter used).
No. The gel & probe need to have contact with the skin. Ensure no clothing or dressings obscure skin contact.
No. Although the BioCon bladder scanners provide you with a live image of the bladder, the settings do not allow you to see any fine detail such as seeing the pelvic floor move. NICE Guidelines: 1.3.19      Imaging. Do not use imaging (MRI, CT, X-ray) for the routine assessment of women with urinary incontinence. Do not use ultrasound other than for the assessment of residual urine volume. [2006] 1.6      Assessing pelvic organ prolapse. Do not routinely perform imaging to document the presence of vaginal prolapse if a prolapse is detected by physical examination. [2019]
You may simply want to check that patients are not in retention, however you can use the bladder scanner for many other reasons, for example: • Reducing unnecessary catheterisations • Confirm catheter blockage • Checking post void residuals • Reducing the risk of urinary retention • Part of a continence assessment • Trial Without Catheter (TWOC) • Monitoring hourly output/kidney function • Suspected voiding dysfunction • Recurrent urinary tract infections (UTI)
No. Once you have located the bladder, the unit automatically calculates the bladder volume. Do not keep moving the probe between scans if you have found a good image of the bladder. Just alter the pressure and contact a little, as you may get a better image, or alter the angle slightly. Positioning the probe midline, approximately 3-5cm above the pubic bone normally finds the bladder easily. 2-3 scans per patient is recommended, to ensure you pick up the largest possible volume. Monitor ‘current’ versus ‘max’ volume between scans.
No. The pink cross merely confirms the presence of fluid. Within the ‘pre-scan’ window you are able to view a live image of the bladder. You need to be able to visualise the bladder (shown in black), if in any doubt the pink cross confirms you are seeing fluid.   Pink cross on bladder scanner As long as the bladder is central in the screen (by aligning the green vertical line down the middle of the bladder) your bladder will be fully captured within the cross hairs (as shown on the results screen). The auto correction tool within BladderPoint™ ensures that even if the bladder is off centre, your readings will be captured (as long as the whole bladder can be seen within the scanning cone).
  1. Foetal use or pregnant patients (safe but not accurate as it will pick up amniotic fluid).
  2. Patients with ascites (safe but will pick up ascitic fluid).
  3. Patients with open wounds or damaged skin in the supra-pubic region (risk of infection when using ultrasound gel).
Based on the Mcube paper roll shipped with each scanner (5 rolls), set to raw image view: approximately 38 scan prints per roll with a warning (red edge print) that there is enough paper left for 4 more printouts. Based on de Smit Medical’s paper roll box of 20 rolls (code BC5D-0020(20)) raw image view: approximately 58 scan prints per roll with a warning (red edge print) that there is enough paper left for 4 more printouts.
Please refer to BioCon-700, BioCon-900, BioCon-900S, and BioCon-1100, for the most up to date cleaning and disinfection instructions and materials.
BioCon-700 No. However, patient records can only be accessed through the scanner’s internal review function or by uploading the data to a PC and read using the proprietary software supplied with the scanner. If removed from the scanner the memory card is encrypted and cannot be read unless the MCube software is installed on your PC.
BioCon-900 Encrypted.
BioCon-900S/1100 Yes. Encrypted and PIN protected (option within set up function)
The current reading displayed is the one most recently acquired. The max reading displayed is the highest volume captured in a sequence of readings. When printing a record, regardless of the most recent reading captured, it is the max volume and corresponding images that are printed. NB: When capturing pre- and post-void measurements, once the pre-void reading has been taken and recorded it is recommended that the ‘new patient’ button is selected to clear the reading ready for the post-void phase to be measured. It is recommended that you do 2 to 3 scans per patient. Monitor the ‘current’ reading to check all scans are giving consistent readings, this will build your confidence and scanning technique.
No routine annual calibration is required for any of the BioCon bladder scanners. However, if your BioCon hasn’t had the latest calibration software installed (updated from Jan 2019) you may still need an annual calibration. The calibration software is back upgradeable on all units. Contact de Smit Medical to determine your software levels if in doubt.
The whole BioCon range will display volumes between 0 – 999ml. If a bladder contains more than this the scanner will display 999+. NB: an empty bladder can be difficult to locate and may not be clearly visible on the screen.
Absolutely not. This may damage the probe and will invalidate any warranties. Refer to our cleaning instructions for compatible cleaning solutions and methods.
No. To ensure greater accuracy, and to ensure all ultrasound rays transmit through the skin, only ultrasound gel should be used (approximately size of 10p). Any other lubricating gel should be avoided as we cannot guarantee that all the ultrasound rays will be transmitted through the skin, therefore compromising accuracy. To reduce any infection control risk, place the gel directly onto the probe, having first cleaned the probe.
No. The BioCon bladder scanners are only able to read fluid and designed for assessing bladder volume only.
Within the 'pre-scan' window, you can view a live image of the bladder. This ensures that you can locate the largest/best image for greater accuracy and ensure the bladder is fully captured for a centred reading. The BioCon bladder scanners read fluid volume only and do this automatically. The scanner settings are fixed. Ultrasound images displayed are to aid bladder location for greater accuracy.
No. The battery capacity and characteristics described above ensure that a spare battery is not required. Integral batteries last 3 ½ years (when in normal use). Therefore, possibly a further 1-2 batteries may need to be installed during the bladder scanner’s lifetime.
No.  The battery charges whilst in-situ in the scanner and does not have to be removed.
BioCon-700 & 1100 Can also be used whilst connected to the mains supply.
BioCon-900 & 900S Battery operated only.
Under the scanner set-up facility (home screen) a variety of scanner settings are user definable. The only settings we recommend for the smooth operation of the scanner are described below under the scan set up section: BioCon setup (images from BioCon-700)   'Image reverse' should be off                                           'PreScan BladderpointTM Please note: BladderPoint™ (pink cross) is available on the complete range of MCube bladder scanners. Older models can be upgraded to BladderPoint™ software. Should the scanner be deemed to not function correctly, please check that these standard settings are selected. The BioCon-900, 900S & 1100 settings are pre-set. Speak to your EBME department or local de Smit Medical representative. Also refer to the operator manual.
A fully charged battery will provide up to 6 hours of continuous scanning. BioCon-700                                                      2400 scans BioCon-900, 900S & 1100                               1000 scans The scanner automatically powers down after 7 minutes of inactivity (default setting) to preserve the battery’s charge level. The batteries do not discharge when not in use, they are not on standby.
For high BMI patients, BioCon bladder scanners have a deep scan depth. Please note when scanning high BMI patients, greater pressure may need to be applied in order to achieve a reading (depending upon depth of adipose tissue). In certain patients, you may need to lift the ‘apron’ to gain better access to the abdomen.
Scan depth is different between adult & child settings, to accommodate high and low BMI patients: BioCon-700                                        Adult mode 18cm         Child mode 8cm BioCon-900 & 900S & 1100              Adult mode 23cm         Child mode 8cm[/expand]
Any patient weighing less than 25kg (55lbs) is suitable for the child setting (includes neonates) as it is a shorter scan depth – 8cm. Ideal for low BMI patients too.
  • Set to male for any adult patient with no uterus.
  • Set to female for any patient with a uterus.
The female setting allows the scanner to compensate for the presence of the uterus. (A very small amount of fluid is held within the uterus - approx. +/- 10ml but varies depending upon condition/medication/number of childbirths etc):

BioCon-700 & BioCon-900        Set to male for any adult patient with no uterus.

Set to female for any patient with a uterus. BioCon900S & 1100                  Has the facility to identify patient who has had a hysterectomy (no uterus).
All bladder scanners use an algorithm to derive bladder volume (results below are tested on a phantom bladder).
BioCon-700 0-999ml +/- 15% or 15ml (0-999ml) whichever is the greatest.
BioCon-900 0-999ml +/- 15% or 15ml
BioCon-900S 0-99ml ±10ml,
100-999ml ±10%
BioCon-1100 0-99ml ±7.5ml,
100-999ml ±7.5%
Please note: K Claxton, Cheltenham, found the BioCon-700 to be accurate to 3% compared with a cone beam CT scan, on real patients across all clinical users. Contact de Smit Medical for a summary.
Yes, as long as ultrasound gel is applied on the probe prior to placing the sheath and then again on the outside of the sheath.