How to give an enema. Medical care for a child

FUNDAMENTALS OF FIRST AID
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How to give an enema. Medical care for a child

Fundamentals of First Aid (OPMP)

Enemas children are made to cleanse the intestines, as well as to administer medicinal substances. Homemade enemas are done mainly for the purpose of cleansing the intestines for constipation and food poisoning. Mechanical irritation of the intestinal mucosa with liquid and water temperature enhances peristalsis. Therefore, with atonic (lack of intestinal tone) constipation, it is recommended to inject liquid with a temperature of 18-20 ° C and even lower, while with spastic (excessive intestinal tone) - with a temperature of 37-38 ° C.

Contraindications for cleansing enemas

Appendicitis.

Intestinal bleeding.

Prolapse of the rectal mucosa.

The first days after surgery on the abdominal organs.

Technique of setting a cleansing enema for infants

1. Lay your baby on their back with their legs up. With clean hands, take a boiled rubber balloon (pear) and free it from hot water that could get into the middle during the boiling process (to avoid accidental burns of the rectal mucosa!).

2. Type in a balloon 100-150 ml of boiled water at a temperature of 28-30°C.

3. Lubricate the tip of the balloon with vaseline and carefully, effortlessly insert into the anus.

4. First, point the tip slightly forward, then, bypassing the external and internal sphincters of the anus, slightly backward, inserting to a depth of 3-5 cm.

5. Then slowly press down on the balloon. For a cleansing enema, a newborn is given 25-30 ml of water, a baby - 60-150 ml.

6. After injecting the liquid, squeeze the baby's buttocks with one hand and gently pull the tip out with the other. Keep your buttocks clenched for some more time to prevent fluid from escaping when your bowel movements increase.

7. After a few seconds, and perhaps immediately, the baby will have a desire to defecate.

Cleansing enema technique for older children

For cleansing enemas, older children use Esmarch's mug.

1. Lay the child on his left side with his legs pressed to his stomach.

2. Pour boiled water with a temperature of 20-22 ° C into Esmarch's mug, then, by opening the tap, let the air out of the rubber tube and fill it with water.

3. Hang the mug so that it is 50-75 cm above the child.

4. Place an oilcloth under the child so that its free end descends into the bowl.

5. Lubricate the rubber tip with petroleum jelly and, spreading the child's buttocks with your left hand, insert it into the anus. The tip is first introduced slightly forward towards the navel, and then back, parallel to the coccyx to a depth of 5-10 cm. Children 2-5 years old are injected with 150-200 ml of water, older children - 200-500 ml.

6. Regulate the flow rate of the liquid using a valve located on the rubber tube. When you have finished injecting the liquid, carefully pull out the tip.

7. The child should lie down for 8-10 minutes until peristalsis increases and the urge to defecate appears. Enhances peristalsis by adding glycerin or vegetable oil to the liquid that is injected into the intestines (1-2 tablespoons of oil per 500-800 ml of water).

Oil enemas

In children, oil enemas can be used as cleansing. Less often they are used for inflammatory processes in the large intestine. In the case of spastic constipation, the oil introduced into the intestines envelops the dry stool and facilitates their removal. In addition, the microbial flora of the large intestine partially breaks down the oil, and the fatty acids that are formed during this irritate the intestinal mucosa and increase peristalsis.

1. Take sunflower, hemp or vaseline oil and heat it to a temperature of 37-38°C. Then dial into a pear-shaped rubber balloon.

2. Put the rubber tip on the bottle.

3. Gently insert the tip through the anus into the rectum and slowly inject 80-150 ml of oil. It is better to do this procedure in the evening before going to bed, because the cleansing effect usually occurs after 8-10 hours.

Hypertensive enemas

Used as cleansing enemas for atonic constipation. A hypertonic solution (10% sodium chloride, 20-30% magnesium sulfate solution) in a volume of 50-70 ml at a temperature of 25-30 ° C is introduced into the intestine using a rubber balloon with a tip. The pronounced effect occurs in 20-30 minutes. This time the child should lie down, refraining from defecation.

Siphon enemas

Relate to washing. The introduction of a large amount of water contributes to its penetration into all parts of the large intestine and the immediate removal of feces, harmful products that got there. Such enemas are used in cases of poisoning with chemical and vegetable poisons, insufficient effectiveness of cleansing enemas, and if dynamic intestinal obstruction is suspected. They are contraindicated in appendicitis, peritonitis, gastrointestinal bleeding, anal fissures, prolapse of the rectum, in the first days after surgery on the abdominal organs.

Siphon enema technique

1. Depending on the age of the child, prepare 5, 8 or 10 liters of clean warm water.

2. On one end of the rubber tube with a diameter of 0,8-1 cm and a length of up to 1,5 m, put on a wide glass watering can, and attach a rubber tube like a thick gastric tube to the other end.

3. Put the child on his back, put an oilcloth under him. Substitute a vessel under an older child.

4. Lubricate the end of the tube with petroleum jelly and insert it through the anus into the intestine to a depth of 20-30 cm.

5. From a teapot or mug, fill the watering can with water and lift it up. Water from the watering can through the system begins to flow into the intestines. When the water level in the watering can is equal to the attached rubber tube, lower the watering can to the level of the child's pelvis. According to the law of communicating vessels, water with washed particles of intestinal contents returns to the watering can - it must be poured into the basin.

6. Fill the watering can again with clean water, raise it 80-100 cm above the bed and monitor the flow of water into the intestines. The procedure should be performed calmly, with interruptions, since intestinal spasms may occur on the water that is injected, and then you need to wait for it to relax.

7. Continue rinsing until clear water begins to drain.

8. After flushing, carefully pull out the tube, rinse the entire system and boil.

9. During the performance of a siphon enema, gas should be observed in the form of bubbles in the liquid. The absence of gases in the wash water is one of the signs of intestinal obstruction.

Therapeutic enemas

With the help of such enemas, children are often injected with a decoction of chamomile (for flatulence), a 2% solution of chloral hydrate (for convulsions), antibiotics in the form of emulsions in warm fish oil, rosehip or sea buckthorn oil (for colitis, if the child often vomits) and others. drugs. The therapeutic solution is injected into the intestine after a cleansing enema.

Author: Basharova N.A.

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