post colonoscopy position

  1. Hi! Just wanna ask everyone how do u position patients after colonoscopy.

    We're told to keep them in prone position to press the abdomen and keep the air out; however it is not mentioned in the books.

    The doctor already takes the air out from the colon as he comes out, so is there still a need to keep patient in that position?
    Most of our patients usually asks to go to the toilet after the procedure, though their colon are empty anyway.

    We're drafting a policy & procedure guideline in our dept so we are unsure if we need to mention positioning post procedure.
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  2. 12 Comments

  3. by   renerian
    I had it and they had me sidelying and yes you still expel LOTS of air LOL.

    Had oral scopes as well, lots of gas and I was prone for that one.

    renerian
  4. by   LibraSun
    There shouldn't be so much air left in the colon that it requires the patient to be contorted! Unless there is something obstructing the natural flow (tumor, stricture, etc) the pt should be able to expel any air naturally. However, if your are a teaching facility w/ newbies or unfortunate to have an incompetetent/uncaring attending there may be an unusual and uncomfortable amount of air left which positioning may make more comfortable---but I would hope that this is rare!!
  5. by   EndoRN
    Yes, the doctor does take air out as he comes out. But it's not 100%. There is always some air still left that the pt. will need to expel. I'm an advocate of rectal tubes. It need only be inserted 1-2 inches. It also helps pts. get rid of the air more QUIETLY! Our pts. recover in a pretty crowded recovery area that includes eye and plastic pts.
    If there was difficulty getting into the terminal ileum, or a lot of time spent in the R. colon for any reason (polpectomy, whatever). There is usally trapped air that is harder to get rid of. And rectal tubes don't really help air up that high. Positon changes and walking as soon as possible are key.
    As for lying prone......that's a new one for me. Ours recover in a side-lying position, usually left. But when they are awake enough, we let them move around however they want.

    Amy
  6. by   ENDOgal
    We usually have the patient return to a supine postion before taking them to the REc. Room. However, if the complain of gas, we move them to a left lateral postion for releif. Howerever, once they return to Same Day Surgery (or Inhouse room) and are more awake getting up & walking tho the restromm usually always ....helps!
  7. by   renerian
    Amy quiet air release.............I am LMBO.........

    renerian
  8. by   LibraSun
    Wow! Rectal Tubes????? That seems extreme!! I have had 3 colonoscopies by 2 different GI doctors and suites and I have never been placed in any position but supine.

    Who takes the rectal tube out? and when? Does the pt wake up with the tube still in?
  9. by   EndoRN
    LOL. I guess I never thought of those little rectal tubes as "extreme".
    With propofol they wake up pretty quickly so I guess I would say the tube's in about 10 min. Give or take. The recovery room nurse takes it out. Though they've been known to forget and it just falls out on the way to the bathroom.

    Amy
  10. by   renerian
    Hahaha I can see the rectal tube falling on the floor on the way to the john LOL. sorry funny mental image.

    renerian
  11. by   LibraSun
    What is the theory behind putting in a rectal tube? That the pt can't pass the air naturally? How do you decide who gets one?
    I am incredulous that a healthy person would need (let alone tolerate) a rectal tube for a routine colonoscopy. Do you think this has anything to do with the age of the endoscopist?
  12. by   EndoRN
    Still debating rectal tubes? Sigh...guess I don't know the "theory" behind them.
    All I know is the patients seem to have an easier time getting rid of the residual air. Patients can relieve themselves of the air a lot quieter (our recov. area is jam packed and not the most private place in the bldg).
    "age of the endoscopist" doesn't really seem to be a deciding factor in the placement.
    About 1 inch of tube is lubricated and inserted. Instant air return. You'd have to go crazy w/the thing to cause damage.

    I guess I just don't know what else to say about rectal tubes. LOL. Other than I want one when I get scoped!!

    Amy
  13. by   RN-PA
    Originally posted by EndoRN
    Still debating rectal tubes? Sigh...guess I don't know the "theory" behind them.
    All I know is the patients seem to have an easier time getting rid of the residual air. Patients can relieve themselves of the air a lot quieter (our recov. area is jam packed and not the most private place in the bldg).

    I guess I just don't know what else to say about rectal tubes. LOL. Other than I want one when I get scoped!!

    Amy
    Our recovery area in the GI lab is only separated by curtains and I personally would have trouble "letting fly" to rid myself of air. (I barely let my husband hear my flatulence, let alone a bunch of strangers-- I know, I know, I'm wierd...:imbar) Anyhow, like EndoRN, I will be asking for a rectal tube when ~MY~ time for a colonoscopy comes.
  14. by   patsue53
    We usually just tell our patients that it will be easier to expel the air if they stay on their left side.......but then I tell mine that they can lay however they're comfortable. We don't have a written policy about it. I kind of look at it as one of those issues that the patient should be allowed to control....they'll fart if they need to, we don't need to give them instructions in the fine art of it.

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