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There are still physicians at the hospital where I work ordering milk and molasses enemas. Is anyone else out there still using these?! If so, what is the procedure followed for mixing and administering?
Yes, we had one ordered by a doc a few months ago on our floor (med/surg). We printed out the recipe from the hospital intranet and hand mixed it on the floor. It called for milk and black strap molasses, which the supervisor bought at the store, and it was heated in the microwave, but only to about 105 degrees. It was instilled like any other large volume enema. Was very messy, and wasn't all that effective.
We still do them on a fairly regular basis. They're effective, if rather messy. (I do admit to having a good laugh the first time I saw one ordered. I sat there for about thirty seconds going "What kind of enema? Is this a joke?" --and then the light went on in my newbie-nurse brain about that gallon jug of molasses I'd seen in the clean utility room... )
We typically use 2% milk in a 50/50 ratio with the molasses. Skim will not work; you need the fat content to get the process moving. (Some of our techs will also 'spike' the mix with half-and-half for this reason.) Either way, have a bedside commode and lots of blue pads at hand!
I had never heard of this til about a year ago. I, too, laughed when I first heard the doc tell me to try it on a pt. I was told it is a 'surefire' fix for an impaction. It wasn't very effective but this was a very extreme case of impacted stool. Took lots of different methods to get the pt relief.
I had a physician order it, but the pharmacy said we don't carry molasses. I called CS and the kitchen, but there was again, no molasses. I finally called the doctor back and asked if we could just do a tap water or soap suds enema. He was okay with the soap suds...which made me wonder why he ordered the milk and molasses enema. It was a whole bunch of headache when it could have been easier to order something more standard. Not to mention the annoyed patient who wanted the enema NOW. Sigh.