Giving an emema on the right side?

[Future LPN Sheryl]

I have learned in school that to give an enema you place the pt. on the left side. But my mother who has been an RN for 40 years says that it should be given to a pt lying on the right side so you can get the assending colon, she says on the left, you only get the decending colon and you don't effectively remove all the stool or as much as possible. I'm wondering if anyone has any info on this, and if possible, where I can back up this info? It makes sense to me. Has anyone heard of this?

[meownsmile, BSN, RN]

I was taught you give it with patient on their left, then have patient roll to right side. It moves it into the ascending colon that way, evacuating more of the bowel.

[NRSKarenRN, BSN, RN]

Author: Joseph Garcia Stafrace C.G.N (England)

TECHNIQUES

Basic aspects of enema administration are proper positioning of the patient, optimal volume of enema solution, infusion rate, and experience needed by the person giving the enema. Due to the atonomical situation of the rectum and sigmoid area, the left lateral position with a bit of head tilt, (trendelenburg position) is the ideal position. The pre- procedural digital examination is fundamental to check for stool and determine if the patient has fecal impaction, haemorrhoids, fishers, polyps, fistulas, rectal prolapse or any other abnormal external pathology. Special consideration must be given to patients having pelvic radiation (fragile rectal tissue and radiation protitis increase the risk of perforation), or patients in ITU or CCU due to tension exacerbation and other cardiopulmonary problems from lying flat for the enema. Pediatric patients are in a class of their own from all aspects, even the psychological point. Pre-procedural digital examination should be standard; it`s your passport to a safe journey within.

http://www.geocities.com/HotSprings/Spa/4773/enemas.html

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From CB Fleet Enema Company: RE Fleets enemas

Professional Use Warnings:

Do not use in patients with congenital megacolon, bowel obstruction, imperforate orifice, or congestive heart failure. Use with caution in patients with impaired renal function, pre-existing electrolyte disturbances or a colostomy, or in patients on diuretics or other medications that may affect electrolyte levels, as hypocalcemia, hyperphosphatemia, hypernatremia, or acidosis may occur.

Directions:

Left side position:

Lie on left side with knee bent, and arms resting comfortably.

Knee-chest position:

Kneel, then lower head and chest forward until left side of face is resting on surface with left arm folded comfortably.

http://www.cbfleet.com/pass2/prod_lax_fleet_enemas_enema.htm

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Enema Administration + Constipation managment in Narcotic Induced Constipation--includes Milk and Molasses enema mixture

http://www.texascancercouncil.org/gftocp/opioid_side_effects.html

[night owl]

I guess that about sums it up Sheryl...I was always taught and give enemas on the left side except for this one resident we have. He insists that we give it to him on the right no matter what we tell him. And so it goes...FLEET... WE MAKE THINGS HAPPEN. (Fleet bank's motto)

[frannybee]

I wondered about this just the other day. If nothing else, having the patient on their left side enables the right-handed nurse to maintain safe body alignment whilst giving the enema! Of course this isn't the original reason for left-side positioning, just a 'handy' co-ink-i-dink.

[aimeee, BSN, RN]

I was taught left side, roll to right after.

Karen--I get a 404 Message not found when I try the link for the Texas Cancer Data Center.

[NRSKarenRN, BSN, RN]

RE posted Cancer center link and was able to access it tonight. Try again!

http://www.texascancercouncil.org/gftocp/opioid_side_effects.html

[RNPD]

I learned left side in school, as the descending colon is on the left side of the body, and is the part of the gut just past the rectum as you go from the distal point (the orifice). But I really never thought that the fluid got anywhere past there-even with a high colonic, I didn't think it would reach the transverse colon, much less the ascending colon, all the way across the body on the right.

[P_RN, ADN, RN]

Our docs called that a "rotational enema." You start on the left, then the back, then the right.....and continue a couple of times.

Seemed to work. Right only doesn't follow any anatomical formation.

[jschut, BSN, RN]

Nope, we were taught always on the left too.

Julie:)