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Discussion

Enemas in the OR suite......????

I'm four weeks new to the periop setting and was originally supposed to train as a circulator. After 4 days they begged me to instead work in the pre-op area and I've been doing great thru trial and error. One day we had given fleets enemas as ordered (x2) to a patient. When pt taken back to OR, the surgeon ordered 2 more enemas to be given in the OR suite while the patient was under anesthesia (urological procedure). I know I'm new to this but isn't that a no-no considering the OR environment??

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  • Experts

If they are under anesthesia, you aren't going to see any results in normal cases. You have also put the bowel to sleep. Chances are the patient has had either a spinal or a general for anesthesia.

I would love to know the reason for this. We do surgery on the bowel all of the time, so that isn't any different, but would love to know the reason why they are getting it immediately pre-op as well as during the procedure, unless he has had a patient in the past that had some type of cpmplication.

Ususally enemas are alsways given the day before surgery.

Pt.'s undergoing cysto cases with spinal anesthetics frequently "poop" during the procedure. Perhaps the surgeon got his wingtips soiled on a previous case.

  • Experts

And to give another enema while in pre-op, as well as the OR?

Something is not right there.

I responded to this question shortly after it was posted, but some-how didn't make it, so I would like to add my 2 cents.

I agree with the others, something is just not right here.

One, BM'S in the OR are something we avoid!!! I saw an ortho doc cancel a case because the pt had a BM after the spina, but before we started!!

As the others have noted, doing an enema after anes. has started is frankly, a waste of time,,,,at best you'll be doing a rectal irrigation. At worst, you are looking at fecal contamination in your OR.

If the doc is that concerned, he maybe would be well off to do some sort of bowel prep a day or two before. Liquid diet, and laxatives like Go-Lytely come to mind. If need be, maybe a fleets enema prior to going to the pre op area, making sure the pt has had time to "finish the job", first!!!!

Mike

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