An Enema, also known as a clyster is an injection of fluid into the lower bowel by way of the rectum.
Enemas are rarely used with children unless a part of preoperative preparation or are required for radiological study.
The usual amount of enema solution used are as follows-
- Infant: less than 250 ml
- Preschooler - 250-350 ml
- School age child - 300-500 ml
- Adolescent - 500 ml
For an infant-
- Use a small soft catheter (no 10 to 12 French) in place of an enema tip.
- Infants and children up to ages 3 years or 4 years are unable to retain enema solutions, so they must rest on a bed pan or baby pan during the procedure
- Pad the edge of the pan so that it is not cold or sharp.
- Place a pillow under the infants or the young child’s upper body for positioning and comfort.
- Lubricate the catheter and insert it only 2 to 3 inches (5cm – 7cm) in children and only 1 inch (2.5 cm) in infants.
- Be certain to hold the solution container no more than 12- 15 inch above the bed surface so the solution flows at controlled rate.
- If the child experiences intestinal cramping, clamp the tubing to halt the flow temporarily and wait until the cramping passes before instilling any more fluid
- If the enema solution is to be retained, such as an oil solution, hold the child’s buttocks together after administration
- Tape water is not used because it is not isotonic and causes rapid fluid shifts of water in body compartments, leading to water intoxication.
- Normal saline (0.9 sodium chloride) is the usual solution