To our 14th newsletter for Health Care Professionals.
Evidence on Alarms for enuresis
Malem enuresis alarms, the MO3 series, have been in general use
in Australia for 5 years – based on over 20 years of clinical
experience with Malem Alarms for nocturnal enuresis. Several randomised
trials have used the Malem alarm to generate the evidence that alarm
management of enuresis is effective. A new Cochrane review and meta-analysis
considered 53 trials involving 2862 children. (Glazener, Evans and
Peto; The Cochrane Library, 2004: www.cochrane-renal.org ) Glazener
et al. concluded after the review that……
“alarm interventions are an effective treatment for nocturnal
bedwetting …alarms appear more effective than desmopressin
or tricyclics by the end of treatment and subsequently.”
produced the first body-worn alarm in 1980. The standard Malem alarm,
based on that prototype, now comes in 4 colours: orange, red and
green; each with a different single tone and the yellow alarm with
8 tones. The sounds from Malem alarms are available on our website.
Go to: www.enuresis.com.au
Malem Alarms to solve your problem Malem are now introducing new
models. A new family of alarms, the Ultimate series, was demonstrated
at the recent World Paediatric Nephrology conference in Adelaide.
The Ultimate alarms have a great potential for solving problems.
Around 80% with Monosymptomatic Nocturnal Enuresis have bedwetting
that resolves with the use of a standard Malem alarm. However some
children do not respond or relapse. There are others with day-time
wetting or with disability who require special solutions.
Ultimate MO4 series differs from the “standard”
MO3 alarms in that they all offer the options of sound plus vibration,
vibration alone or sound alone. In the MO4 these options are set
with an internal control by the parent or professional. Combination
alerting may wake those who sleep deeply and do not wake easily.
The MO4 series use standard AAA batteries. This makes them suited
to those providing alarms as a rental service, from a public clinic
or in the bush where the specific hearing aid batteries used by
the MO5 may be less available. All Malem alarms can be used with
body-worn flat or clip-on wetness sensors or bed- mats.
The Malem Ultimate Gold alarm provides 8
sequential sounds to choose from as well
The question of which signal best arouses a heavily sleeping child
is frequently raised. The recently introduced Malem ULTIMATE
Bedside Alarm MO6 is the loudest in the range of Malem
Malem Ultimate bedside MO6 was developed to use with the Malem bed-mat,
but can be used with the body-worn sensors or with the clip on sensor
(eg clipped to the sheets).
The Bedside MO6 has the option of recording a voice message or
using a selected sound (the recorded alert option evolved after
suggested only his dog’s barking would wake him). The MO6
provides a bedside alarm with the option of using spoken instructions
recordable in parental voice. This offers possibilities for special
situations, such as the Autistic child for who alarm noises are
too disturbing. The MO6 is an alternative to the Ramsey Coote alarm,
at a much lower price. Professionals can ask to evaluate an MO6
on a “sale or return” basis – call June on:
1800 803 756
or at www.enuresis.com.au
The Malem Ultimate 1 + Record MO5
body worn alarm provides vibration and/or auditory signals AND
also has the option to record and play-back a message. This has
possibilities for managing a child’s daytime wetting and
has potential for use with the physically disabled and intellectually
Jenny is an autistic child aged 15. Jenny cannot cope with
a noisy alarm. She is now wearing a Malem Ultimate + Record
alarm using her mother’s voice to tell her to “go
to the toilet”. Jenny likes her new alarm and.the new
strategy is producing a good outcome in our first evaluation
of the Ultimate Record in Australia.
Malem Ultimate wireless system the TX and the RX is
a new product; and a major improvement on the previous Malem wireless
wetness alerting system. Using radio signals between a wetness sensor
and the alerting device (alarm) avoids wires and can separate the
alarm from the child. Arousal may be by sound or vibration and without
wires. It can be set up as a bedside alarm or/and used to alert/arouse
a more distant parent, nurse or carer…again of value with
deep sleepers and with the autistic or intellectually impaired child.
The Sit-up sensor
The Malem Wireless Alarm can also be used with a sit up sensor.
All other Malem alarms can also attach to the new “sit-up”
sensor. This detects sitting-up, rather than wetness, alerting parent,
nurse or carer to movement. This non-intrusive new device, used
with a Malem alarm helps with the care of those with dementia and
in other conditions.
Alarms and Minirin
In Australia it remains a requirement that an individual must
have been tried with a wetness alarm before desmopressin
(Minirin) can be prescribed as a PBS (ie government subsidised)
medication; or there must be stated a contraindication to alarm
The availability of the range of Malem alarms now makes it unusual
for there to be a need to move to Minirin without an adequate
trial of an alarm. Many clinics observe that dryness from alarm
use often occurs after more than 6 weeks of use, sometimes more
than 3 months. It is important to provide an adequate length
of trial and often this may be achieved if families own the
alarm. Rental from a practitioner’s practice is a possible
option. It is a benefit if a range of alarms is kept allowing
changes if there are problems, for example, with non-arousal.
SQUARE BLADDER STIMULATOR - - IMPROVED !!!!!!!!!!
have been changes in the design of this device. The new model
is more compact, is more robust and, most important, can now
be activated with light pressure – making it more easily
used by those with restricted hand power eg partial quadriplegics.
Malem Alarms for Monosymptomatic Nocturnal Enuresis
MO3 Malem alarm: auditory
MO4 Malem Multitone
Bedside Auditory Alarm for “Resistant”
Nocturnal Enuresis eg non-arousal with M04 or other alarms
MO6 Malem Bedside
Red (with bed-mat)
(for silent alerting of parent with bedside alarm)
improved, easy to use and affordable:
SQUARE BLADDER STIMULATOR
Malem Alarms for “Resistant” Nocturnal Enuresis
eg non-arousal with M03, daytime enuresis, deafness, etc.
MO4 Malem Ultimate Auditory &/or
MO4 Malem Ultimate Multitone
Malem Alarms for Enuresis in special situations
eg non-arousal/autism/physical/brain impaired
(sound &/or vibration plus recorded sound)
MO7 Malem Wireless
(sensor, transmitter & receiver with alert)
products are being sold at competitive prices - no need
to buy from overseas
Overnight delivery is available at standard delivery charge to capital cities,
1-3 days to regional areas.
Malem alarm orders:
Post and packing: $A10.00 per item
Negotiable on large orders
Malem Medstat & Enuresis Advisory Service
Tel: 1800 803 756
Medstat & Enuresis Advisory Service
Tel: 1800 803 756
Fax: 07 54785024
Write to: PO Box 112
Montville QLD 4560
News was compiled by June Jenion of the Enuresis Advisory Service
with the invaluable assistance of contributors and comments from
other experienced staff who check the Newsletter prior to publication
and Enuresis Advisory Service
Call Australia Wide.
803 756 or contact us by following this