Therapeutic and protective mode

The patient takes the same position as in the formulation of cleansing enema (on the left side or back with a slightly bent at the knees). Flexible end of the rubber tip, lubricated with sterile petroleum jelly, injected through the rectum to a depth of 20-30 cm siphon action of the enema is based on the principle of communicating vessels. Attaching the funnel to the outer end of the tube, it is kept in several inclined position, at the level of the patient's pelvis and fill the rinsing liquid - pure boiled water, weak solution of potassium permanganate, a 2% solution of sodium bicarbonate. Funnel lift up, approximately 30 cm above the level of the body, after which the liquid begins to flow into the intestine. Once the liquid in the funnel reaches its restrictions, the funnel quickly lowered below the level of the patient's body, and it starts coming back filled with fluid from the gut along with bubbles of gas and feces. Flipping the funnel and pouring the contents, fill with water and wash procedure was repeated again as long as the intestines into the funnel will not come clean rinse water. Typically, one siphon enema requires 10-12 liters of fluid.

Drug-related therapeutic enemas enema with the introduction of various drugs. Medicinal enemas are the most likely micro enemas and their volume is usually 20-100ml.  

For medicinal use of enemas rubber balloon or pear-shaped syringe Janet Long rubber tip (catheter), which is injected into the rectum to a depth of 10-12 cm before applying them, as a rule, pose a cleansing enema.  

Nutritive enema. After a cleansing enema and intestinal emptying-ka, flatus, bowel give 20-30 minutes to calm down, then enter the sterile tip connected thereto, or a mug Esmarha with a dropper or a special system for the introduction of nutrients to the tube system imposes adjustable clamp that provide 30-40 drops per minute (the rate of administration of substances with a nutritional purpose). The patient is conveniently placed, carefully harbor, and the procedure lasts 2-3 hours, depending on the amount of nutrients needed for administration. Introduction rate is regulated in accordance with the possibility of the patient does not respond to the procedure (the solution should not bleed from the rectum, and should not cause the urge to act of defecation).  
 

Appliances setting the vapor tube.  
 

Gazootvedenie carry a thick-walled rubber tube 40 cm long and 8-10 mm in diameter. One end is rounded and it has two side openings, the other slightly enlarged. The indications for the introduction of the vapor tube is the accumulation of gases in the intestines (flatulence) and the presence of spasms indoor or outdoor zhomov anus.  

Patient explain the purpose and procedure of manipulation. On the sheet trail oilcloth, top to cover her diaper, turn the patient on her left side and asked to pull his knees to his stomach. If the patient can not be put on the left side and manipulation is carried to the patient lying on your back with knees bent and legs apart. The vapor tube lubricated with sterile vaseline. Left hand pushing the buttocks and gently introduce it into the anus to a depth of 20-30 cm outer end of the tube is immersed in a bedpan, which poured in some water (because the gases can be allocated a small amount of liquid stool).

Care should be taken that the tube was in the patient's intestines are not more than 2 hours to avoid the formation of bedsores. After 2 hours, gently remove the pipe and tempted patient. The tube was placed in a marked capacity for disinfection, then treated according to the Ost 42-21-2-85 and sterilized.  

Sometimes the introduction of the vapor tube can be difficult because of the accumulations of the large amount of feces, so before this manipulation to make the cleansing enema with glycerine and chamomile.  
 

Bedsores.  
 

Decubitus - a dystrophic ulcer-necrotic processes arising-repentant debilitated patients, a long time being in bed. Most often, pressure ulcers are formed in the shoulder blades, sacrum, greater trochanter, on the elbows, the occipital region, back of the heel.  

Promotes the formation of bedsores bad skin care, uncomfortable bed, a rare perestilanie. One of the earliest signs of bedsores - pale skin and smyatost, followed by redness, swelling and peeling of the epidermis. Then there are blisters and skin necrosis. Accession infection can lead to sepsis and cause of death.

Preventing pressure ulcers: 

1) turning the patient on his side several times a day, if his condition allows (to change the pose of the patient); 

2) every day several times a day to shake the sheet to avoid crumbs in the bed; 

3) ensure that on bed and underwear had no wrinkles and patches; 

4) Seriously ill, long-term are in bed by placing an inflatable rubber circle wearing a pillowcase, so that we find the rump-dilsya over the hole of the circle; 

5) daily wipe the skin with a disinfectant solution: camphor spirit, vodka, cologne, and in their absence, wipe the skin half of competence dipped in warm, soapy water and wipe it dry, lightly rubbed with the skin. 

To wipe the end clean towel moistened with disinfectant and wipe gently squeeze the neck, behind the ears, back, buttocks, the front surface of the chest and armpits. Particular attention should be paid to the crease under the breasts, where obese women may be formed diaper rash. Then wipe dry skin in the same manner. 

These procedures are performed daily at night patients who can not take weekly hygiene bath, as well as patients being in a coma. Thus, if properly cared for leather patient should always be clean and dry.