>> The second delivery method we're going to discuss is a Foley catheter. With that,
we're going to gather your supplies. We're going to use an enema bag. You're going to
need a connection device and you're going to need a Foley catheter. The size of the
Foley catheter will be determined by your physician. This is a 24 French Foley catheter.
This Foley catheter has a balloon. You're also going to need a 10 ml or 10 cc
luer lock syringe, lubricating jelly and a tape measure.
One of the first things that you're going to do is to take your Foley catheter and test
your balloon. The reason why we administer these types of enemas are again retention
enemas. The balloon, once it's inflated inside the rectum, is going to retain the fluids
of the saline enema inside the rectum so that there isn't any leakage or seeping around
the catheter.
We're going to take our 10 cc luer lock syringe. We have to fill it up with air, and the way
we do that, we pull back on the plunger until you get to the number 10. You're going to
attach the syringe to the end of the balloon port of the Foley catheter. The way to attach
the syringe is to press down and turn clockwise to the right. You're now going to infuse the
balloon with air. This balloon will need to be infused with 15 milliliters of air. You're
going to remove the luer lock syringe off of the catheter and pull back an additional
5 milliliters. Again, place it on the top of the balloon portion, turn it clockwise,
and infuse.
While you are maintaining pressure on the syringe, you're going to twist off
counter clockwise and remove the syringe. The reason you need to maintain pressure while removing
the syringe is that had you not maintained pressure, the air from the balloon would actually
deflate.
So, now we're going to remove the air that we place in the balloon. We've already tested
it. We made sure that the supplies are functioning. So we're going to remove the air by attaching
the syringe and pulling back on the syringe to remove the air.
And if you see, it's now deflated.
So, inserting the Foley catheter, you need to know how far to insert it. So, you're going
to need a measuring devise and we are going to measure 4 inches from the tip of the
catheter and mark it. This is how far you will insert the catheter.
Now, we have the enema bag here. This is your standard enema bag
that comes with a sliding clamp, again
to adjust the flow of the saline, roller clamp open, roller clamp closed. You'll need both
hands to actually close this roller clamp.
The tip of the enema bag already comes pre-lubricated and if you noticed, there are holes here.
Because we won't be using this tip of the enema bag, we'll actually be using this tip
of the Foley, we'll need to remove this section of the bag. We'll take a pair of scissors, cut.
There's no rhyme or reason to the length that you'll need to cut, you'll just want
to get rid of the end portion that contains the holes. You're now going to take the end
of the enema bag and connect it to the Foley. The device that we need to connect it to,
we need to use a clear connecting device; otherwise, these two devices will not connect
securely.
We will take the connecting device. One end will go into the enema bag.
The other end will connect to the Foley.
You want to make sure these are secure.
And now you have your system.
So, again, we're in the bathroom, we're on the floor, we have towels, we have Johnny,
he's comfortable. First thing that we'll do, close our slider clamp. We're going to add
fluids in. We're going to use the same number as previously used, we'll use 500.
Now, this bag is a little bit trickier to use because the opening is a little bit smaller,
so be careful and certainly you can prime it over your sink.
Now that we have the connection secure, we're going to prime the bag. The way that we do
that is open the slider clamp. That will allow fluids to go and purge through the tubing,
to the end of the catheter. You'll need to use both hands for this section.
The fluids will prime pretty quickly.
The fluids have been primed through. Remember, the higher the bag, the faster the flow.
Now, we're ready to begin. Remember, that after the enema has infused, we have to stay in
this position for an additional 10 minutes so that the solution fluids will be retained
in Johnny's rectum.
We're going to lubricate the tip of the Foley catheter.
We're going to separate the buttock and insert the catheter.
I find it very helpful when inserting a Foley catheter or an enema
of any sort, it's easier to tolerate if you insert the catheter with a twisting motion
as opposed to a straight insertion. It just makes it easier for the children to tolerate.
We're going to insert it to our mark. Now, this should not be uncomfortable for Johnny.
He will feel the catheter, but he shouldn't feel any discomfort. Once the catheter is
in place, we're going to inflate the balloon. If you remember how to do this, we're going
to pull back the air to 10, attach the syringe, while applying pressure, remove the syringe.
We'll pull up an additional 5 milliliters, attached the syringe, apply pressure and remove.
If you notice, we are now taut inside of Johnny's rectum. Now, it's time to infuse
the solution.
While the fluids are infusing, you'll want to hold the catheter so that it doesn't migrate
back and forth inside Johnny's rectum. If it were to migrate inside further, it wouldn't
cause any damage, your fluids would just leak out. Once the infusion has completed, you're
going to hold the catheter in place for a period of 10 minutes. It has now been 10 minutes
and it's time to remove the Foley catheter.
Very important step: You must first remove the air out of the balloon.
We're going to attached the syringe and withdraw
the air.
So, what would happen if you did not remove the air from the balloon?
It could also - it could cause some discomfort and you would
not be able to remove the catheter.
So, I am feeling some tension because all of my air is empty out of my balloon.
So, again, first thing remove the air out of the balloon. Now it's time to remove the catheter.
Now it's time for Johnny to sit on the commode for a period of 30 to 45 minutes.