Saw my first disempaction yesterday! - page 3

I know this is silly, but I saw my first disempaction yesterday and I nearly lost my lunch (well, the little I'd had time to eat before being called away). How do you handle these things? Strangely... Read More

  1. by   ShortFuse_LPN
    Originally posted by P_RN
    Just remember disimpact others as you would like to be disimpacted yourself.

    :chuckle :roll

    Funny! But I agree. I have seen nurses who seem to be trying to feel for tonsils while disimpacting!

    Speaking from may want to double glove....
  2. by   cargal
    Originally posted by Nurse Ratched
    [B There is a technique to it because you don't want to stimulate the vagal response.

    Not one of my favorite things to do, but as others have said, you just have to think about the relief you are giving the patient.

    No one ever taught us the technique to prevent vagal response! I can't find any information on it. Please share!
  3. by   PerkyCardiacRN
    Originally posted by Caveman
    Glass Eye....

    When I was in high school my best friend had a glass eye. One day on the way to school an older guy ran the stop light right in front of the school, hit my friend's car in the rear fender, and spun it around. My friend was not hurt at all, but, being the smart-a$$ that he was, and wanting to put on a show for the gathering crowd, he removed his "eye" before getting out of the car, and started screaming bloody murder. The guy who ran the red light freaked!!! Thought he was going to have a heart attack.
    Holy cow!

    That's quick thinking!
  4. by   gizzy76
    Thanks so much for the information everyone!

    I suppose I should share the reason this person was disempacted. It was not a case of being constipated or "bunged up".

    The person was a 19 year old male with spina bifida. He gets disempacted every 2-3 days, b/c he is unable to toilet himself. He is able to push a bit which helps to push the stool down a bit while you are digging around. It just completely grossed me out.

    Some of the other staff in our LTC were sharing about this other resident who barely eats but has a large fluid intake being constipated regularely. She was dispempacted the other day and they said that when they looked at her bottom, it looked as though she was giving birth to a 6lb-er. I wouldn't have believed it if everyone had not agreed. I was shocked. This woman needs to be given a suppository on a regular basis almost from the sounds of it b/c she was loose on Tuesday and on Thursday, she was hard as a rock inside. It baffles me completely.
    Any info?
  5. by   TracyB,RN
    Normal to have loose stool around an imapction. . .it's gotta get out somehow, right?
  6. by   Nurse Ratched
    Originally posted by cargal
    No one ever taught us the technique to prevent vagal response! I can't find any information on it. Please share!
    is it must be done gently, as others have more eloquently said, "the Golden Rule of disimpaction" lol. Excessive manipulation seems to cause someone to vagal down; can't really describe it well.
  7. by   ShortFuse_LPN
    Originally posted by TracyB,RN
    Normal to have loose stool around an imapction. . .it's gotta get out somehow, right?
    Yep! And we all know how it gets out when the impaction is too large to get around....
  8. by   NRSKarenRN
    Have gloves and lube...don't mind suctioning...will travel.

    Epitaph's on my tombstone.
  9. by   jayne109
    I disimpacted an older gentleman a few weeks ago. I am a new grad (Dec 2002) and they had always stressed carefullness during this procedure to prevent the vagal response. The most careful was I could think to do it was to have a CNA watch a continuous pulse ox for the pulse. I new that if it dropped very much to get out. It worked for me.

  10. by   Token Male
    "Been there, Done that, Didn't like it."
    I still get grossed out by coughed up, thick, greenish sputum but not much else these days. Remember though a boot full of amniotic fluid early in a shift can ruin your whole day, I found out the hard way why the Obs/Gyn blokes always rolled up their strides and put gumboots on.
  11. by   MICU RN
    And your why there is a nursing shortage?
  12. by   Mimi2RN
    We had a newborn, with feeding problems, we knew the plumbing worked. She had a barium swallow and became impacted. Glycerin supps didn't work...rectal stimulation had been tried, a couple of days went by, no poop.

    Finally I was able to start things moving with a thermometer probe out chunks of barium, she didn't cry, just kept trying to bear down......she was much happier afterwards, and so was her doc!
  13. by   Scavenger'sWife
    Yep...used to think that it would bother me too. Now, after working a few years, I don't think much bothers me at all. I once got called out in the night to the assisted living place I was working b/c a LOL needed dis-impacted. Do you think I could find any silicone? or Vaseline? arrrrgghh... Finally had a brain cell fire: I went into the kitchen and got out a gob of Crisco. Went to the LOL and it worked like a dream! That became our code word: "The lady might need Crisco'ed!" hee hee

    The only time I thought I was gonna lose it was with a deceased hospice patient. I turned him to clean him up before calling the funearl home and a HUGE amount of green ....."junk".....came out of his mouth, nose, rectum,every orifice. EEEEEeeeeaaaaaccckkkk!! But I kept my cool. Thank God I always got the families out of the room before I washed the bodies. Think if THAT had been witnessed by family?