Nervous nurse's guide to ebb and flow enemas

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Specializes in OB, Med/Surg, Ortho, ICU.

This nervous nurse has done it again! Today I gave my first ebb and flow enema. Somehow I've managed to dodge doing these for nearly three years, so I asked some advice from my charge nurse. I already had a good handle on how to do them, but I asked her if I should include the castille soap because the patient was distended from gas and constipation. She thought that it could help.

Do you remember the volcanoes we all made in grade school? Yeah, hold that image. The instant I inserted the tube, the bubbles started and kept coming. Bubbles+soap=foam! Yep, I'll never do that again. Consequently, the patient felt much better, and I learned to not only think things through a little more, but also tiny ladies can hold a heck of a lot of gas. Peace out.

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:lol2::yeah::eek:

I've never heard of ebb and flow enemas...used to give the Triple H....high, hot, and helluva lot :D

My first enema-giving experience in school was, uh.....embarrassing :D

My instructor was there, of course, and the little lady WANTED her enema. So, I got the bag and soap all rigged up, instructor watching me in the bathroom, while standing next to the bed by the lady. I got the bag all set, and the lube packet on the end of the hose. My instructor suggested I let the air out of the tubing (:uhoh3:-duh), which I did.

BUT...... I forgot the packet on the end of the tubing, which shot off across the room like ammo after a deer on the first day of hunting season. Still don't know where it ended up. :eek:

That lady would have been totally within reason to ask me to leave, and find someone who could potentially not blow her up with a recto-oral air bolus :D

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Specializes in OB, Med/Surg, Ortho, ICU.

Ha ha, I love the triple H acronym. They aren't very common any more. We use ebb and flows for gas. It's just a bucket enema that you hold high to fill the bowel, the hold it low to draw out the fluid and a bunch of gas comes with it. This gal was like a jet stream as soon as I open the clamp!

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Specializes in ER.

I've always known them as a Return Flow Enema (RFE).

Wondering if the doc actually writes the order as Ebb & Flow?

Interesting, regional preferences.

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This nervous nurse has done it again! Today I gave my first ebb and flow enema. Somehow I've managed to dodge doing these for nearly three years, so I asked some advice from my charge nurse. I already had a good handle on how to do them, but I asked her if I should include the castille soap because the patient was distended from gas and constipation. She thought that it could help.

Do you remember the volcanoes we all made in grade school? Yeah, hold that image. The instant I inserted the tube, the bubbles started and kept coming. Bubbles+soap=foam! Yep, I'll never do that again. Consequently, the patient felt much better, and I learned to not only think things through a little more, but also tiny ladies can hold a heck of a lot of gas. Peace out.

:yeah:ROFL:lol2: thanks, you made my night!
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Specializes in Hospice / Psych / RNAC.

We use to call them soap suds enema, or is that the same thing? I've never heard of an ebb and tide enema.

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Specializes in OB, Med/Surg, Ortho, ICU.
We use to call them soap suds enema, or is that the same thing? I've never heard of an ebb and tide enema.

We call a soap suds enema a bucket enema. This ebb and flow uses the same setup as the soap suds, apparently minus the soap. You just hold it high and low for a few passes to let the fluid in and out to pull the gas out.

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Never heard of this type, but it makes some sense.

All enemas are somewhat embarrassing, I think, but pts are usually thankful after some relief is obtained.

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Specializes in Post Anesthesia.

I've never seen this ordered, let alone given one, but it sounds like what the "altrnative medicine" clinics do with "colon cleansing". Enamata (the pleural of enema) have always made me nervous. The right temprature has to be added to the 5 rights of med administration if you don't want to put your patient into agony. Without a KUB x-ray or CT how do you know you are not pouring 4quarts of nonsterile fluid into a ruptured bowel? If you do get it into the colon, you are giving a HUGE fluid bolus when the gut absorbs what dosen't pass back out. A "fleets" to stimulate distal activity is pretty simple and safe, but pouring gallon of liquid into an already disfunctional colon never seemed safe to me.

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I've never seen this ordered, let alone given one, but it sounds like what the "altrnative medicine" clinics do with "colon cleansing". Enamata (the pleural of enema) have always made me nervous. The right temprature has to be added to the 5 rights of med administration if you don't want to put your patient into agony. Without a KUB x-ray or CT how do you know you are not pouring 4quarts of nonsterile fluid into a ruptured bowel? If you do get it into the colon, you are giving a HUGE fluid bolus when the gut absorbs what dosen't pass back out. A "fleets" to stimulate distal activity is pretty simple and safe, but pouring gallon of liquid into an already disfunctional colon never seemed safe to me.

You ever see the photos of what they get back from colonics? :eek: It looks like something that needs carbon dating, and a LOT of it!! :D Never seen a 'standard issue turd' look like that :)

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the ebb and flow enema has been known as a Harris Flush and I usually used to patients with gas.

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the ebb and flow enema has been known as a Harris Flush and I usually used to patients with gas.

Thanks, this old nurse was wracking her brain trying to remember what they called them where I worked.

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