Algorithm for performing a cleansing enema

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ACCREDITATION AND SIMULATION CENTER
CLEANING PROCEDURES
Moscow, 2024

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Algorithm for performing a cleansing enema
An enema is a curative and diagnostic procedure that involves the
introduction of various liquids into the lower segment of the colon.
Depending on the purpose, there are two types of curative enemas:
cleansing and medicinal.
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Types of enemas
Cleansing:
• macro
- cleaning and siphon
• micro
- hypertonic, oily.
Medicinal:
• siphon contrast macroenema
• nutritious (drip)
• medicinal microenema
(introduction of drugs into
the rectum)
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Cleansing enema
Mechanism of action:
- the injected liquid during a cleansing enema has a mechanical,
temperature and chemical effect, enhances peristalsis, loosens feces
and facilitates their removal
- the mechanical effect of the enema is better, the greater the amount
of liquid.
Goal: to achieve cleansing of the lower colon
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Cleansing enema
Indications:
• preparing the patient for x-ray examination of the digestive, urinary and pelvic organs;
• preparing the patient for endoscopic examination of the colon;
• for constipation, before administering a medicinal and nutritional enema;
• preparation for surgery, childbirth.
Contraindications:
• bleeding from the digestive tract;
• acute inflammatory and ulcerative processes in the colon and anus;
• malignant neoplasms of the rectum;
• the first days after operations on the digestive tract;
• cracks in the anus;
• rectal prolapse.
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Algorithm for gastric lavage
- is an instrumental manipulation in which a probe is inserted into the stomach cavity
for therapeutic or diagnostic purposes. Probe manipulations are carried out both as
planned and for emergency indications for therapeutic or diagnostic purposes in a
medical organization.
These include:
• gastric lavage with a thick/thin probe
• intubation of the stomach with a gastric or nasogastric tube
With the help of gastric intubation, you can rinse the stomach, obtain the contents of
the stomach with its subsequent examination, administer medications, and artificially
feed the patient through a gastric or nasogastric probe.
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Algorithm for gastric lavage
Indications:
• acute poisoning (food, poisons);
• removal of stomach contents in case
of gastric atony and high intestinal
obstruction;
• gastritis with abundant mucus
formation;
• release of the pathogen during
inflammatory processes in the
bronchi/lungs (when swallowing
sputum) and infectious diseases of
the stomach.
Contraindications:
• acute
gastrointestinal
or
esophageal bleeding;
• organic
narrowing
of
the
esophagus;
• singe of the mucous membrane of
the larynx, esophagus, stomach;
• acute
myocardial
infarction,
stroke, unstable angina;
• maxillofacial injuries;
• epilepsy with frequent convulsive
seizures.
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Possible difficulties and complications during
gastric lavage
1. Less liquid flows out of the funnel than was introduced into the stomach. Perhaps
some of the water enters the intestine, or the probe is bent and prevents the normal
outflow of fluid. The probe should be withdrawn slightly.
2. The removal of fluid from the stomach has stopped. Perhaps the probe holes are
clogged with blood clots, mucus, or food particles. The probe should be removed and
cleaned.
3. Damage to the mucous membrane of the esophagus and stomach, which can lead to
bleeding and blood entering the respiratory tract.
4. Penetration of rinsing water into the respiratory tract with the development of acute
respiratory failure.
5. Damage to the vocal cords when the probe enters the larynx (the patient develops a
cough, a feeling of lack of air, and a blue face).
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THANK YOU FOR ATTENTION!
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