14) Raising of nasogastric probe.

A patient occupies comfortable assidenous or semilying position. Measure off necessary length of probe : distance between an ear and tag of nose (А-В) and from a nose to the underbody of breastbone (В-С). Designate this place on a probe by means of pencil or ribbon. Ask a patient to do nose-blow. Choose a nostril through that you are simpler to breathe. Dip the tag of probe in a vessel with water; it will facilitate introduction of probe. Incline a chairman back and enter a tube in the nostril chosen by you. Ask a patient to lean forward, when will feel that a tube reached to the throat. Continue to enter a tube farther. That a tube moved up downward, a patient must do swallowing motions, as though drinks water sips. It is necessary deeply to inhale, that vomitive reflex was not. Move forward a tube carefully, does not press on her. Move forward a tube until a mark on her will not attain a nose.

Make sure, that a probe is entered correctly by aspiration of gastric content.

15) Realization of cleansing enema.

A cleansing enema targets at dilution and exception of content of bottom department of colon.

1. For raising of cleansing enema it is necessary to have a mug of Esmarch, stand, vessel on 1-2 l of water of room temperature, oilcloth, pelvis, vaseline oil, rubber gloves.

2. Close a faucet on the rubber tube of mug of aseptic. Implant a aseptic tip on a tube, check up safety of tip. Fill with the mug of aseptic on third of volume water. Rubber gloves put on. Open a faucet on a rubber tube and fill all system water by producing of her by small portions through a tip. A faucet on a tube is closed.

3. A patient is inlaid on left on the edge of bed or couch with doubled in to the stomach feet, that assists weakening of muscles of abs and facilitates to introduction of liquid to the bowels. Under the buttocks of patient lay an oilcloth that is let down from a bed to sex. Put a bedpan (if by chance a patient will not be able to retain water and will produce her back.

4. Oil a tip vaseline oil, take it the fingers of right arm. Take the right buttock of patient a left arm up to the top. Enter a tip easy circulating motions in an anus. The first 3-4 cm enter a tip towards a belly-button, and then yet on a 5-8 cm, in parallel to the coccyx. It is impossible to enter a tip with effort, because it can result in the wound of wall of bowel. If present folds of mucous membrane or haemorrhoidal knots, enter a tip between them, trying them not задіти.

5. Lift the mug of Esmarch on a height a 1 m above a couch and fasten it on a stand. Open a faucet on a rubber tube. If water does not act to the bowels, it can be predefined by that a tip abuts against the wall of bowel or in a hard excrement. A tip is drawn out on a 1-2 cm and again stick forward. If a rectum hammered in by an excrement, try to wash out his stream of water. Sometimes the excrement masses are such hard, that putting an enema is not succeeded. At that rate it is necessary to delete an excrement from a rectum the finger in a rubber glove, smeared by vaseline oil.

It is necessary to watch after speed of receipt of water in bowels, regulating this process in high position of mug of Esmarch. The rapid receipt of water can cause appearance of pain, urge to defecation.

It is necessary to remember, that cool water irritates bowels, and strengthens their peristalsis. Application of cold water is not desirable, because she can cause the spasm of bowels, stomach-ache and delay of emptying at spastic constipation.

Empty the mug of Esmarch to the not end. On the bottom of mug abandon a bit water, to prevent entering of air bowels. After introduction of liquid a faucet on a rubber tube is closed and destroy a tip from an anus gradual circulating motions. Dissociate a tip from the system, dip him in a 1 % solution of chloramine, then boil during 15 min Mug of Esmarch is washed, wipe, keep in a closet that stands in a room for realization of enemas. After introduction of liquid a patient must detain her in bowels during 5-10 min It is arrived at by that he calmly lies on a back and breathes deeply.