Rektal infusion

[Roguish Lawyer]

What a shitty thread.



















Sorry. Couldn't resist.

[ccrn]

QUOTE]Originally posted by DoctorDoom
.... it would appear from your first post[/QUOTE]

I was referirng to not only a binder ie lactulose but tap H2o enema etc also. I would challenge anyone to retain a liter of saline or any other type of water rectaly for more than a few moments or minutes let alone enough fliud for resuscitation ie vascular collapse assuming a pt had enough rectal tone to do so.

I'd also like to add that rectal route is not exactly expediant or conveniant in emergent situations ie TNCC.

Considering someone prehospital will not get the many units of PRBC, colloids/hespan etc ,alot more than one liter will be given...

Stand back I say....

Based on my experience in the ICU and ER, and stories Ive heard of in the OR I think it would not work.

If 91W carries IV equipment into the field with leg units I cannot imagine how a highspeed unit, if even a foreign one , would not have the capability if not more. Of course there is the scenario of mass casualty etc but triage sorts that out however unfortunate.

I cant imagine either a terminal DNR/DNI pt accepting rectal fluids if not recieving other routes. Of course DNR does not mean "Do Not Treat" and we will often still treat them aggressively for better or worse. Ive been in this situation many times, (and hospice and palliative) in a few different regions of the country and have never even seen or heard of it mentioned let alone done. More sound to advance NGT or feeding tube instead-

ccrn

[DoctorDoom]

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[DoctorDoom]

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[ccrn]

Originally posted by DoctorDoom
...may be construed as a pissing match. That is certainly not my intent; I have enjoyed and learned from this discussion.

Not taken that way at all.

Interesting articles but not research however, not to mention 6 and 7 years old respectively.

Also they conflicted each other regarding the use of normal saline.

Are you aware of any independently duplicated research that is current to support the use of "proctoclysis" fluid administration either in the palliative/hospice or trauma pt?

ccrn

[52bravo]

and the bowle perfusion in shock is not same as it is in cancer, i think the perfusion is the big one here

[DoctorDoom]

x

[DanUCSB]

The more I hear/read about it, the more it seems to fall into urban myth status. That is, I've always heard of it being done, and everyone seems to have a "friend of a friend" who it was performed upon, but I have yet to run into some that's actually either performed it, or have had it performed on themselves.

That's not to say that it's not a valid procedure, or something else to have in your bag of tricks... either way, it's beyond my current expertise (which tops out at the SuperCLS/CPR level). It just seems to be a procedure that is far more talked-about than actually implemented.

[Kyobanim]

I'm just glad there weren't any pictures to accompany this thread.

[DoctorDoom]

x

[DanUCSB]

Now I feel dirty.

I had to go back and make sure that that wasn't what I had actually typed, otherwise I'd feel -really- dirty.