Objectives 1. Define the bowel irrigation. 2. Enumerate the indications of bowel irrigations. 3. Mentions the contraindications for bowel irrigations. 4. Understand and the ability t apply the procedure. 5. List the complications for bowel irrigations. 6. The ability to educate the patient regarding of bowel irrigation
Definition medical process involving the rapid administration of large volumes of an osmotically balanced polythelyen glycol solution (Golytely, Colyte), either orally or via a nasogastric tube, to flush out the entire gastrointestinal tract.
Indications Substance will not bound by activated charcoal. Medications that are slowly released over 12 to 24 hours. Massive ingestion with a significant delay. Toxic solid object. Presence of pharmachomabenzoars.
Contraindications and cautions. 1. Nausea and bloating, bowel with aspiration, anal irritation and discomfort secondary to diarrhea are common, vomiting with aspiration. 2. GI hemorrhage, bowel obstruction, perforation, ileus, absent gag reflex, uncontrollable intractable vomiting, hemodynamic instability or compromised unprotected airway. 3. Unstable patient or at risk for a depressed level of consciousness.
Contraindications and cautions Cont’ 4. Aggressive use of antiemetic may be required to control bleeding. 5. Polyethylene glycol electrolyte solution decrease the adsorptive capacity of activated charcoal and therapeutic drug. 6. the traditional method of installing air while auscultating over the epigastrum to confirm the placement is not reliable
The Procedure Equipment : 1. Small – bro gastric tube. 2. Enteral feeding bag. 3. Bedpan to 8 L of a polyethylene glycol- balanced electrolyte solution. ( PEG – EBS ).
The Procedure Cont’ Patient Preparation : 1. Insert a gastric tube. 2. Place the patient on up right position. Procedural Steps : 1. Administer the PEG – EBS either orally or by gastric tube at 1 to 2 L / hr. 2. If vomiting occurs, slow the administration rate and gradually increase the rate as tolerated. 3. Continue administration of the solution until the rectal effluent is clear.
Patient Teaching 1. Setting up on commode. 2. Frequent wiping may cause rectal irritation. 3. The procedure may take 4 to 6 hours to complete. 4. Additional liquid bowel movement may occur after completion of WBI.