Saline enema (1353)

What is an enema and why is it needed?

An enema may be needed when stool must be removed from the rectum. An enema means that liquid is put into the rectum. The liquid makes it easier to pass stool. A saline enema is made from salt water (saline).

What supplies are needed?

• Lukewarm water. The water should feel warm but not hot.
• Salt
• Measuring spoon
• Enema bag and rectal tube
• Lubricant such as Lubafax® or K-Y Jelly®
• Permanent marker to mark length of rectal tube
• A potty chair or the toilet close by so that your child may use the chair or toilet easily.

Follow these steps

1. Gather your supplies.
2. Wash your hands with soap and water. Count to 10 while you wash your hands, then rinse and dry.
3. Measure and mix the amount of water and salt recommended by your child’s health care provider.
4. Measure the rectal tube for the proper length. Mark the length with a permanent marker. Your child’s health care provider will tell you the proper length to insert the tube.
5. Clamp the rectal tube shut. Fill the enema container with the water/salt mixture after the clamp on the rectal tube is closed.
6. Pick up the enema bag and tube. Open the clamp on the rectal tube a little bit. Let the liquid flow through the tube and then close the clamp again. This removes air.
7. Use your finger to spread lubricant on the end of the rectal tube below the mark on the tube. Brand name lubricants include Lubafax and K-Y Jelly (Figure 1).
   
   
8. Position your child in one of the two shown positions (see Figure 2 and Figure 3).
   
   
9. Gently place the tip of the tube into the child’s rectum to the distance you marked on the tube (Figure 4).
   
   
10. Hold the container of liquid about 3 to 4 inches above the child. Open the clamp and allow the liquid to flow into the child’s rectum. If the water does not flow into the child’s rectum raise the bag a few more inches to get it started. Gently hold the tube in place as the liquid flows in.
11. When the container is empty, remove the tube. Put the kit to the side and wash it later for storage.
12. Have your child hold the liquid inside for 3 to 5 minutes. If your child is too young, then gently hold the buttocks together to keep the liquid inside.
13. Help your child to the toilet or potty chair. Very young children may release the liquid into a diaper.
14. Praise your child for helping with the procedure.
15. You may be asked to write down the results of the enema such as how the stool looked and how much there was.
16. Rinse the enema equipment and let it air dry or throw it away if the directions tell you to do so.
17. Wash your hands. Be sure to wash with soap for as long as it takes to count to ten.

How will an enema feel to my child?

An enema may be uncomfortable. Sometimes as the liquid goes into the rectum, a child might feel some cramping or feel like they need to have a bowel movement.