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Rigid sig - get from OT or CSSD - with light source
Lube (lots of packs)
PPE: bluies, long-sleeved gown, mask with eye shield, double long gloves
Rectal tube, drainage bag, flexitrak
Fleet enema to put up tube? Nurse assistant
Positioning: left lateral with knees up, like colonoscopy; bottom near edge of bed; bed at comfortable height, assistant on opposite side supporting patient/holding them still
No analgaesia usually required DRE to maximum
Light source on
Lube up and insert scope, aiming towards umbilicus
Insert under vision to navigate rectal folds - insufflate with trapdoor at back closed, with lowest pressure that allows you to see mucosa
Insert to hilt
Stand back and flick open trapdoor
Place rectal tube through channel and use the trochar to push it all the way up, holding it there as you remove the tube itself
Attach to bag and secure with flexitrak
+/- fleet
Check abdomen for improvement, useful to get a baseline AXR after decompression
If inadequate decompression, needs OT
