Enemas for GI bleeders?

[canoehead, BSN, RN]

A patient was admitted with a lower GI bleed, and was doing for a colonoscopy. The surgeon requested enemas til clear. I have my doubts about that being a safe practice, my gut says don't put anything in there that might exacerbate the bleeding. Wondering what everyone else would do with that order?

[xtxrn, ASN, RN]

The colonoscopy can't be done with a chunky poop chute...so yeah- I've given enemas til clear for GIBs going for a scope. Even after the "Go Litely" (whoever named that was just plain demented). It's going to give the doc more info to help the pt with an accurate scope...just go gently, and don't let the water get TOO warm (don't want to freeze them out either). If the bleed was low enough to be a risk for exacerbating, I'd think the doc would know from the color of the stool already passed..... anything about poop color in the H&P?

Good luck - and breathe through your mouth :)

[Jenni811, RN]

They need to do the colonoscopy to see where the bleed is coming from.

i had a GI bleed that had a tap water enema until clear. It was a huge mess, required 2 RN's and a CNA to do it. But, we got it done.

You may not want to do a barium enema, but something like a tap water enema is just water, its going to come right back out. No harm in doing it, your only doing it to clear the bowel so physician can see when he/she can see where the bleed is coming from. But it's great that you question things if you feel they are unsafe.

[Jenni811, RN]

And yes, i agree with xtxrn. you want warm water, not cold. but you don't want it too warm. Like body temperature warm, not hot tub warm. :)