Okay, I have a really dumb questions, but bear with me, I'm still kind of a newbie!!! I had an ex- 26 weeker the other day, who is now about 34 weeks (corrected). The other day, the NNP ordered a suppository (glycerin slicer). So as I'm attempting to do this, I'm thinking, there is no way I'm gonna be able to get this sliver in there. I know with adults, you can use your finger to push the suppository in, but what do you guys do with little preemies?

Our glycerin suppositories are supplied by our pharmacy in prefilled TB size syringes. We lubricate the tip and only place it in as far as if you were doing a rectal temp. Works like a charm!

Yeah, we do the 1cc syringe thing too, except we fill them ourselves.

On my unit, we have two different types of suppositories: Solid, and liquid glycerine (solid being the adult type "plug").

We use the TB syringes with the liquid glycerine, and usually fill them ourselves from a bottle that pharm sends up. The solid kind usually come with a scalpel that we use to slice off a thin sliver. To actually insert it if I can't get it in with my gloved fingers, I lubricate the tip of a five fr silastic catheter and use the tip to push it in. In my experience, I have to devote a few minutes to this task holding my thumb in place so the tip isn't pushed out and has time to soften a bit. The silastic cath's work well because they're soft and flexible and five fr is good because it's so tiny and doesn't hurt the anal tissue.

I hope this is the information you were looking for ! :)

Kristi

On my unit we use the glycerine suppository but only give the little one a 1/4th of it. We cover it with KY Jelly and insert it rectally. You don't have to force it in but I just hold my finger on there little bottom in case they force it back out before it has melted. Sometimes parents get grossed out by it but hey it is all in a days work :)

What a great idea. (Filling the TB syringe with the sliver) I've been in the NICU several years and I still learn something new everyday!

The syringe thing doesn't work if the supp is a drug rather than glycerin. Part of the supp stays in the syringe's dead space.

Thank you guys so much. I've never heard of the TB syringe or the cath trick! I love my allnurses buddies!!!

We use the syringe way too and keep a box of supp in the frig.

We use a syringe attached to a 6F feeding tube and lube the tip. Usually give 1/4cc glycerin to micros and 1/2 to 1 cc for the rest.

Heather

We also keep a stock supply of glycerins in the fridge.

A funny story... I needed one and the stock supply was empty. So I called the pharmacy to ask for more. I guess it was a new pharmacy tech because I had to explain my situation to 2 different people. Then they wanted to know the baby's name so they could look it up in the computer, which it wasn't entered yet. So I say I'll enter it. Then they say no, you'll have to fax the actual order before we can fill it. But aren't they a stock item? No we HAVE to SEE the order before we can send you a glycerin suppository. Okay fine, be stingy with the glycerins.

So I have the secretary fax the order over... with a big STAT sticker on it. Just because, haha.

I know, it sounds impossible to give a preemie a suppository, but it is fairly common practice where I have worked. We cut a sliver off the side of the suppository with a scalpel blade and use KY jelly for lubrication. It usually goes in easily enough, but sometimes you have to just hold your finger against the orifice for a few minutes so they don't shoot it out again !!!!!:roll