High-Volume Colonic Enemas: Using Rubber Catheter (4 of 4) – CHOP GI Nutrition and Diagnostic Center

>>So, this is our third and final delivery method of providing a saline high-volume enemas. At this point, we’re going.

>>So, this is our third and final delivery
method of providing a saline high-volume enemas. At this point, we’re going to use a red rubber
catheter. If you notice with this catheter, it does not have a port for a balloon inflation.
This size of this catheter is a 24 French. That is actually going to be determined by
your physician or nurse practitioner, but you will use anywhere from a 24 to a 26 French
red rubber catheter. The rest of your supplies will remain the same. You’ll need an enema
bag. You’ll need a connecting device, water soluble lubricant, and a measuring tape. So, one of the first things that we’re going
to do, we’re going to measure the catheter and mark it to give you an idea of how far
to insert this red rubber catheter. Now the difference between this catheter and the Foley
catheter, one, we don’t have a balloon so we won’t be retaining any fluids with the
help of a balloon. In addition, we’re actually going to go farther inside of the colon than
you would with a Foley catheter. So, we want to measure and mark the distance
that we’re going to insert the catheter. We’d like to measure at a point of 6 inches and mark it. And again we’re going to measure at 10 inches and mark it. The maximum that you
will insert the red rubber catheter is 10 inches. You do not want to go beyond 10 inches.
So now we’re going to connect all of our supplies. We’re going to take the tubing from the enema
bag, connect it to the red rubber catheter by way of the connection device. Simply insert the connection device into one
end and the red rubber catheter into the other. Make sure all
your connections are secure. You’re then going to take your bag and get
it ready to receive the fluids. First thing you need to do?
Make sure your slider claim is closed. You’ll need two hands to make sure that the clamp is closed. So, again, we’re going to use the same amount
that we’ve been using, which is 500 milliliters. Again, based off of your physician or nurse
practitioner’s orders. It’s time to hang the bag, and we’re now going
to prime the fluids through the tubing. You’re going to need two hands. You prime it by opening
the slider clamp. It will prime through quickly. And close the roller clamp. And now we have
Johnny in position on his left side. We’re going to lubricate the tip of the catheter. And we talked about how far we’re going to go
in. You want to take a look at your markings, 6 inches and 10 inches. While Johnny is on
his side, you’re going to spread his buttocks and insert the catheter. We talked about ease
of insertion by placing the catheter inside and inserting it in a twisting motion. This is not a painful procedure. Johnny will
feel the catheter, but he shouldn’t be uncomfortable. Once the catheter is in place, we’re going
to hold it in place with our hand and we’re going to open the slider clamp to infuse the enema. While the fluids are infusing, massage Johnny’s
stomach. Again, you’re going to need to hold the catheter in place so that it doesn’t migrate
in and out of the rectum. Once all the fluid has been removed from the bag, you’re going
to hold this catheter in place for a period of 10 minutes. Once the catheter has been
removed, you’ll need Johnny to sit on the toilet for a period of 30 to 45 minutes to
fully evacuate his colon. During that time, you can use that time to
actually clean your supplies. You can rinse out your bag and your catheter with warm soapy
water and let it air dry.

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