浙江大学_21580.pptVIP

ENEMA TIP INSERTION Before the enema tip is inserted, the opening in the back of the patients gown should be adjusted to expose only the anal region. The rest of the patient should be well covered when the rectal tube is inserted. The patients modesty should be protected in any way possible during the barium enema examination. The right buttock should be raised to open the gluteal fold and expose the anus. The patient should take in a few deep breaths before actual insertion of the enema tip. If the tip will not enter with gentle pressure, the patient should be asked to relax and assist if possible. The tip should NEVER be forced in a manner that could cause injury to the patient. Because the abdominal muscles relax on expiration, the tip should be inserted during the exhalation phase of respiration. The rectum and anal canal present a double curvature; therefore, the tube is inserted first in a forward direction approximately 1 to 1? inches (2.5 to 4 cm). This initial insertion should be aimed toward the umbilicus. After the initial insertion, the rectal tube is directed superiorly and slightly anteriorly to follow the normal curvature of the rectum. The total insertion of the tip should not exceed 3 to 4 cm to prevent possible injury to the wall of the rectum. The rectal tube may be taped in place or held to prevent it from slipping out while the patient turns back into a supine position for the start of fluoroscopy. This position is usually supine but may be prone, depending on the preference of the radiologist. If the retention-type tip is necessary, most departments allow the technologist to instill one or two puffs of air into the balloon end to help hold it in place. However, the bulb should be filled to its maximum only under fluoroscopic control as the fluoroscopy procedure begins. As the procedure begins, the IV pole supporting the enema bag should be no higher than 24 inches (60 cm) above the radiographic table. SUMMARY OF ENEMA TIP INSERTION PROCEDURE