Equipment

Special consideration

Catheters

The catheters used should be soft. Do not use Naso Gastric Tubes with a weighted

Nelaton urine catheters

tip. Nelaton catheters are softer and less likely to damage mucosa
Orders should include specific size, and length of catheter to be inserted
Weight

Size

Length to be inserted

Weight < 2kg

Size 8FG

Weight > 2kg

Size 10FG Nelaton

Nelaton

2-3cm
5cm

Confirm orders with treating surgeon/doctor if they vary from the above guide

Syringe

Terumo 60mls catheter tip syringe

Normal Saline
Sachets 0.9%

Ensure normal saline sachets are warmed prior to use (warm to touch). Infants, especially
premature infants can cool quite rapidly if solution is cold. Volume of saline to be used is
determined by the surgeons and should be written as an order

Lubricant

Use only water based lubricant

Inco-sheets

Use inco-sheets to protect soiling of bed

Process

Position infant, usually on his/her back with legs in the frog

position
Select appropriate sized catheter for use
Warm normal saline solution and prime catheter
Lubricate tip of catheter and gently insert into the rectum.
Length determined by surgical instructions
Instil saline in 10 - 20 ml aliquots (by pushing in with syringe

plunger) over 1-2 minutes(there should be no resistance when

injecting the normal saline).
Remove syringe and let fluid run into nappy/kidney dish
Procedure may be repeated twice if return is not clear
If there is saline retention or return is not clear contact surgeon
Remove catheter from the rectum
Note and record results of bowel washout accurately on fluid
balance chart (MR55B)

Special Consideration

Use inco-sheets to protect soiling

of bed
Do not use excessive force if

resistance is felt. Contact medical

staff if unsure
Do not pull back on syringe to

aspirate, allow the saline to run out

naturally
Do exceed maximum of
20ml/kg