Enema
What is Enema ?
Instillation of any fluid or solution into Large Intestine through Rectum for Various purposes (Bowel Evacuation or to administer medications)
Types of Enema-
1. Evacuant-
In this Enema, Contents of Enema are expelled.
e.g. Simple Evacuant, Purgative, Astringent etc.
2. Retained-
In this Enema, the contents of enema are absorbed in the
body.
e.g. Stimulant, Nutrient etc.
Purposes of Enema Administration
1. To Treat Constipation
2. To induce Peristalsis
3. To give Medication
4. To Stimulate in Shock
Some Important Points before administering Enema-
1. Size Of Rectal Catheter-
Adult = 22-30 Fr
Child = 14-18 Fr
Infant = 12 Fr
2. Insertion of
Rectal Catheter –
Adult = 3-4"
Child = 2-3"
Infant = 1-1.5 "
3. Amount of Solution-
Age
Evacuant Retained
Adult
500-1000 mL 100-500 mL
Child
250-500 mL 50-100 mL
Infant
>250 mL
<50 mL
4. Position-
Sim’s Position (Left lateral Prone)
5. Height of Enema can-
A. Cleansing Enema (Evacuant)- Not more than 18’ (45 cm)
B. Retained Enema – Not more than 8” (20 cm)
6. Temperature of Solution-
A. Evacuant Enema – Adult (105-110 F), Child (100 F)
B. Retained Enema – At Body Temp. 98.6 F)
Contraindications of Enema Administration –
1. Cardiac/Renal Disease
2. Glaucoma
3. Bowel Perforation
4. Appendicitis
5. Recent rectal/
Prostate Sx
Articles needed for Enema Administration-
1. Gloves
2. Disposable apron
3. Pads
4. Lubricating solution
5. Enema Solution
Procedure-
1. Explain the Procedure to the Patient and Obtain
informed consent.
2. Gather all articles.
3. Provide Privacy
4. Perform Handwash
5. Wear Gloves and plastic apron.
6. Check the enema for expiry.
7. Warm the
solution to required temperature.
8. Position the patient on left side (Sims Position)
9. Place a sheet underneath the buttocks of
patient.
10. Assess the area.
11. Remove the enema seal & Lubricate the top of Enema Tube.
12. Separate the buttocks and Insert the lubricated
nozzle into the rectum slowly. (Length of Enema Tube Insertion depends upon Age
)
13. Press the Enema Tube from back to front and Empty
it.
14. Remove the Enema Tube Slowly and Perform
Perianal Hygiene.
15. Ask the patient to retain the enema for
required time and provide Bedpans.
16. Dispose of all waste, remove apron, wash hands.
17. Document the procedure.
