Indication for high fleet enema
- Dilated or “ballooned” rectum – faecal loading proximal to rectum
Contraindications
- Neutropenia, thrombocytopenia
- Per rectal bleed
- Presence of anal tumour
- Complete bowel obstruction
Preparation
- Prepare requisites
- Non-sterile examination gloves
- Apron
- Water-based lubricant gel
- Protective sheet
- Foley catheter (Size 14-16)
- Fleet enema
- Receptacle
- Wet wipes
- Bedpan or commode
Procedure
- Verify patient’s identity and explain procedure and its purpose to the patient
- Ensure privacy
- Position patient in left lateral position with both legs flexed
- Place protective sheet under patient’s hip and buttocks
- Perform hand hygiene and don gloves
- Lubricate tip of the Foley catheter with lubricant gel
- Prime the catheter with fleet enema
- Retract patient’s buttock with non-dominant hand
- Gently insert the lubricated catheter into the rectum till resistance is felt. Do not advance if resistance is felt.
- Instruct patient to do deep breathing during catheter insertion
- Gently instill the enema solution till the bottle is empty, then remove the catheter
- Encourage patient to retain the enema solution for as long as possible or until the urge is strong
- Clean the perineal area
- Assist patient to dress and rest in a comfortable position
- Provide bedpan/commode or put on diapers for patient if incontinent/unable to retain fleet solution
Please click here for a demonstration video of high fleet enema.
Follow up
- Note outcome of fleet enema: colour, amount, consistency of stools