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How To Do Rectal Examination (PR)

Discussion in 'Gastroenterology' started by Egyptian Doctor, Feb 9, 2014.

  1. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    Introduction

    1- Introduce yourself

    2- Wash hands

    3- Check patient details

    4- Explain the examination
    “I need to perform a rectal examination, which will involve me inserting a finger into the back passage. It will be a little uncomfortable, but shouldn’t be painful and will only last a very short time”

    5- Gain Consent
    Request a chaperone


    6- Gain adequate exposure:
    • Ask patient to remove trousers / underwear & to cover themselves with the blanket provided
    • Leave the room & allow them time to do this
    • Maintaining patient dignity is of the highest priority
    7- Position the patient in the left lateral position with their knees to their chest
    Put on gloves

    Inspection

    1- Separate the buttocks & inspect for:
    • Skin excoriation / skin tags
    • Rashes
    • Haemorrhoids
    • Anal fissures
    • External bleeding
    • Fistulae
    Palpation

    1- Lubricate the examining finger

    2- Warn the patient you are about to insert the finger

    3- Insert finger gently into the anal canal

    4- Rotate the finger 360 degrees to assess the entirety of the internal rectum:

    • Note location & texture of any masses / irregularities – e.g. 2cm irregular mass at 11oclock
    • Is there stool in the rectum? – soft vs impacted
    5- In males the prostate can be located anteriorly:
    • Comment on the size / symmetry & texture of the prostate
    • It should be smooth, symmetrical & approximately the size of a walnut
    6- Assess anal tone by asking the patient to squeeze your finger

    7- Withdraw finger
    • Inspect for blood – fresh red vs malaena
    • Inspect for stool / mucous
    8- Clean patient using paper towels

    9- Cover patient with the sheet provided & explain the examination is over

    10- Allow them privacy to get dressed

    11- Wash hands




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  2. Moses Maw Lann

    Moses Maw Lann Young Member

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    Sir,could you send me the physiology of heart with video.I'll be great full to you.Thank you.
     

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