How to apply pressure?

[Whatdouthink]

Can someone help me understand how to apply abdominal pressure during a colonoscopy? It seems like the colonoscopies I circulate are always difficult. I can’t seem to help the endoscopist keep the scope from looping or get around curves. Does anyone have any advice?

[ORnurseLovesHerOfficer]

I always ask the doctor where they think the loop is. I also visualize the abdomen and see if I can see the light from the scope. Our GI dept head taught me that when you are in doubt and other areas aren’t working, start at the belly button and push in and up. It has helped me immensely 

[Whatdouthink]

So if I see the scope looping, is it correct to push there? Or if I can’t see it, just apply pressure in the area that the doctor thinks it is looping? If it still doesn’t work, try at the belly button pushing in and up? 

[mumarada, BSN, RN]

Kelly Osborne got her doctorate on this exact subject.  LINK   I listened to a webinar, she's a big proponent of Colowrap

 

[I<3Endo]

Depends on where the looping is. If I can feel/see the loop forming I apply pressure there. If I can’t, my go-to areas are the sigmoid & across the transverse. In thin women with multiple abd surgeries/scars I find suprapububic often works. In obese pts, straight in at the umbilical area. Avoid the top left as you can cause splenic trauma. I also don’t have much luck with right sided pressure as it often prevents the scope from moving forward or just straight up causes it to fly backward. 
Good luck! Sometimes nothing seems to work. ?