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The scheme began in June, 1959. Since that time little has been reported of the use of
electric buzzers by local authority health departments although they are probably
being widely used by school and enuresis clinics. It is hoped, therefore, that a description
of a scheme not based on local clinics will be of interest to other L.A. workers
in this field.
Administration
The service is based on the area health office in Ealing and is in the immediate
charge of the Deputy Superintendent Health Visitor who carries out all the necessary
visiting herself.
Referrals are received at the area office on a standard form from assistant medical
officers or by letter from general practitioners. It is the concern of the doctor referring
the child to carry out the necessary physical examination and to test the urine.
When an apparatus is available the health visitor arranges to visit the home and
demonstrate the use of the machine. A standard sheet of instructions is also left in
case any difficulty should arise.
Progress cards are supplied so that wet and dry nights may be recorded and as a
guide to progress the time and size of the wet patch.
The parents of the child are advised not to discontinue use of the apparatus until
there has been a three-week period without wetting.
The health visitor calls again at the home after one week to see that the apparatus
is being used correctly. Her next visit will be some three to four weeks after this and
if the child is not then dry further visits will be made at appropriate intervals. All
children are visited again at an interval of between six months and one year after the
buzzer has been removed.
In addition by reason of her other duties the health visitor will have contact with
many families outside these routine visits.
The Apparatus
We were fortunate in having a member of the staff who volunteered to design,
make and keep in repair the requisite number of machines. It was found that 12
machines were necessary to avoid a waiting list.
The wiring circuit is shown in the diagram (Fig. 1). The machine is housed in an
Oxo or similar tin and the components required are a G.P.O. type relay, 6-volt dry
battery, buzzer, light, switch, two yards of twin flex, and two crocodile clips. The cost
of these components is about 21s. There is no charge to the patient.
Experience has shown that the machine must be of robust construction with all
wiring joints firmly soldered.
Mats or pads used in conjunction with the machine are available in various patterns.
Foil mats were used at first, but experience showed that these were liable to tear and
we are now using the wire net type which proves more durable.
Results
At the time of writing 100 children have completed their treatment and have had a
follow-up visit at least six months afterwards. This group comprised 62 boys and 38
girls. Their ages are given in Table I.
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