pain scales

[L's in a jam]

What are other G.I. units using for pain scales after a colonoscopy/gastroscopy? Visual Analog Scale, Numerical Rating Scale, etc.? Do you use a bloating scale also? And how is that set-up? Same as pain scale?

What positioning do you use post colonoscopy for passing flatus? Left, right, supine, prone or any position the pt's. wants to be in? And where is it stated in the literature about what position is best. I've been unable to substantiate why our facility positions the pt. on the left side. Lit. searches and review of textbooks has not given us any answers. Any help would be appreciated!

[bkleja]

We use a numerical scale of 0 - 10 for adults and on ped's it's either a visual scale with smile/frown faces or a 0 - 5 scale, depending on their age. We don't have a bloating scale - I guess I consider that as part of their pain and comment as needed. Our patients come out of their procedures on their left side and we leave them in that position until they pass flatus, or, if none passes after 30 min or so we start flipping them side to side every 10 - 15 minutes. That usually does the trick. I don't like colons to sit up until flatus passes - it's harder to pass that way in my experience. Don't know any specific research to back that up.

[L's in a jam]

Thanks for your reply. Left side seems to be the standard, but I don't know why. I did find one article that promotes pt's. sitting up after the colonoscopy, but I would think that would make pt's. that were bloated a little nauseous.

Thanks again for your input!!

[GIRN]

Actually, our best GI doc has told us to position our patients on their RIGHT side and that seems to work best. I haven't seen it written in literature anywhere but I believe it because I've seen it. We'll try the right side first, then flip to the left after just a few minutes, then insert a rectal tube if there's no results. Having them stand and walk to the bathroom to defecate is sometimes effective, also, after some of the gas has passed.

[L's in a jam]

Thanks for your reply! Don't you find it odd that there isn't any literature out there on positioning post colonoscopoy? I'm curious to find out when we start collecting our research data, what it shows regarding positioning. Maybe the right side will be best. We use ambulating to the bathroom a last resort r/t the sedation during the procedure, but it does work usually. I'll keep you posted.:smiletea:

[GIRN]

The doc that tells us to use the right side is very much into what the literature says. I bet he'll have some literature as a source for his choice. I'll ask him next time we work together.

[L's in a jam]

That would be great if you could ask him about the lit. source for the right side! Keep me posted.

[GIRN]

Sorry...no formal literature. I ran into the doc today and he said he knows this through experience and knowing the anatomy. He said if you think about the patient lying on their right side, the sigmoid colon would be elevated and since gas rises to the top....the air has to come out! He doesn't know of any written sources to verify this either. Maybe you should do a study and publish it and become rich or famous!