Hello fellow GI nurses...abdominal pressure

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    during Colonoscopy .How does your unit handle teaching this to new Endo nurses? Just wondering if there is any formal teaching information out there as opposed to what I traditionally see...trial by fire. Thanks.

    Sandy
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    My gut (ha ha) response is it is not brain surgery but still I know sometimes I am not certain exactly where to apply pressure. Trial by fire isn't the best way to learn new things!!!!

    Sometimes the Dr. will push in a few different areas so he can show the nurse where he wants her to push. It isn't always obvious even to the Dr.

    I do keep a step stool handy. I am not that big and stepping up on the stool gives me better leverage.
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    I don't know if you will look at this site again, but I am humiliated to say I went to an in service on GI nursing yesterday and my abdominal pressure technique, where, why, I thought I was supposed to be applying pressure couldn't have been more wrong.

    If you are still interested I will try to teach what I learned.
    lola129 likes this.
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    Quote from brownbook
    I don't know if you will look at this site again, but I am humiliated to say I went to an in service on GI nursing yesterday and my abdominal pressure technique, where, why, I thought I was supposed to be applying pressure couldn't have been more wrong.

    If you are still interested I will try to teach what I learned.

    I'd be interested in hearing what you learned!
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    Hi, I my notes are at work. I am working Monday so will retrieve them.

    We had an in service on GI nursing because the way GI was being done in our clinic was changing. Since the in service I have not done any GI nursing!!!! We are an out patient surgery, some GI, clinic. It was decided that anesthesiologists would do GI sedation and OR nurses "circulate." I work pre-op, PACU, but because I had done GI in other jobs I had often floated to the GI lab prior to the change.
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    It is really unfortunate that after this wonderful inservice I have not done GI nursing. No practical use of this knowledge!!!! I'm trying to remember from the class and reviewing my notes....... I am really extrapolating a lot from my memory and notes so don't quote me as any expert.

    As the scope is being threaded through the colon... the "tip" of the scope advances, IF the scope starts looping the loop is forming further back, maybe ???? 6 centimeters ???? plus, minus, back from where the tip is. So the purpose of abdominal pressure is to push where the loop might be forming to prevent the scope from looping.

    So where the pressure is applied will change as the scope is advanced.

    The first trouble spot, around 20 - 30 cm (I know it is hard to know, see, how many cm the scope is in from where you might be standing?) But kind of, sort of, if the scope has not gone in too far and starts looping the loops would be kind of "under the bladder" so you would apply gentle suprapubic pressure on the bladder, pushing with your hands flat on the bladded to prevent the scope from looping.

    The second trouble spot would be about 30 - 40 cm the tip of the scope is past the splenic flexure and the scope may be looping in the descending colon, if it starts looping you want to apply a gentle "lifting" of the left lower quadrant (honestly the "lifting" part I don't get, don't remember, exactly what they meant..? apply some posterior pressure also to "lift" the descending towards the patients front???)

    The third area, about 50 - 60 cm in, the tip of the scope has passed through the transverse colon and is in the ascending, if the scope starts looping the loops are forming in the transverse colon. You want to apply gentle upwords pushing of the transverse colon to straighten out the natural u shape of the transverse colon. A gentle upwards pressure in the left or mid upper abdomen, towards the patients head.
    BicyclingBec likes this.
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    Thanks for that explanation. I also have not been taught by fellow nurses the proper technique or what to look for. This helps!
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    It's also worth noting that too much pressure, or pressure released too suddenly, can cause a pt's bp to drop. Always watch the bp when applying pressure.


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