Fleet Enemas: Part 2

Instructions for an enema include the following:

Fleets enemas are best administered by an assistant, friend or family member.

Always drink a couple of glasses of water or juice prior to the enema; this will prevent dehydration.

Lie down on the side with knees pulled towards the chest. Always lubricate the rectal area with KY jelly.

Gently insert the nozzle about 1-2 inches into the rectum and squeeze content of the container.

Remove the nozzle and wait a few minutes for response.

The Fleet Bisacodyl is a ready-to-use enema widely used in most hospitals. The Fleet Bisacodyl Enema is used for relief of constipation or bowel cleansing before rectal examinations. The enema features;

- Protective shield that prevents contamination.
- Pre-lubricated tip for easy insertion.
- One-way safety valve that controls flow and prevents reflux.
- Easy Squeeze bottle.

The Fleet Bisacodyl Enema is a complete, Latex Free enema with a soft, pre-lubricated Comfortip.

To avoid constipation, it is highly recommended that one eat a healthy diet consisting of roughage (whole grains cereals, bran, fruit, and vegetables), 4-6 glasses of water and some type of regular exercise. This helps keep the bowels stimulated and avoids constipation.

For more on fleet enemas, please visit www.medexsupply.com

Fleet Enemas: Part 1

Fleet enemas are generally used to relieve constipation and are meant to be used only for the short term. In most cases, fleet enema is approved for use by a health care professional or a nurse who is fairly knowledgeable about your bowel habits and symptoms. One of the chief reasons why fleet enemas are ordered is to relieve constipation. Other scenarios where a fleet enema may be used is prior to a lower bowel exam, such a sigmoidoscopy, a rectal exam or prior to a barium enema. Some individuals who undergo surgery around the rectal area are often given fleet enema. Fleet enemas are widely available without a prescription over the counter and should never be used for prolonged time.

Once the fleet enema has been applied, the results usually occur in 2-5 minutes. If there is any blood, blistering or pain during or after a fleet enema, your health care physician should be informed.

Fleet enemas should not be used if you have an acute abdominal condition like ulcerative colitis, appendicitis, peptic ulcer disease, nausea, vomiting, fever or lower abdominal pain. Prior to using any fleets enema, it is best to get checked out by a health care professional.

Overuse of fleet enemas can lead to dependence and tolerance to the product.
While fleet enemas are generally safe, the rare side effects include rectal bleeding, blistering, burning or itching.

There are many types of fleet enema and include mineral oil, phosphate or normal saline. For children one should only use mineral oil and normal saline enemas. Fleets phosphate enemas can be purchased from any pharmacy and are indicated for adults only.

Pulse Oximeters : Part 2

Is a pulse oximeter always reliable?

No, there are times when a Pulse Oximetry is not accurate in the following situations:

1.Individuals in shock who are vasoconstricted and have no
pulse generally cannot be monitored by pulse Oximetry. Other
conditions where the pulse may be absent or very faint include
severe dehydration, heart failure, excessive hemorrhage, peripheral
vascular disease, many collagen vascular disorders and other heart
disorders
2.Occasionally bright white lights in hospital rooms can interfere
with accuracy of the oximeter. The numbers may be amplified.
3.The oximeter is sometimes affected by the use of electrocautery
in the operating room. Other medical equipment that can interfere
with the pulse oximeter includes laser beams, ultrasonic devices
and certain types of electronic hardware.
4.Individuals who are shivering or have a persistent tremor often
give unreliable oximeter reading
5.Nail varnish/polish can also cause erroneously low readings.

What are normal pulse oximeter readings?

In general, pulse oxygen saturation in healthy individuals should be above 95% and above. In patients with lung or heart disease, the oxygen saturation may be lower. When the pulse oximeter reads less than 88%, the individual will definitely show difficulty with breathing and may appear out of breaths.

Are pulse oximeters reliable?

Pulse Oximeters available today are very sensitive and reliable. The degree of accuracy has led to their widespread use not only in the hospital setting, but also for use in emergency rooms, out patients medical centers, ambulatory care medicine, outpatient or walk in clinics and even at home.

What is cost of a pulse oximeter?

Advances in Oximetry have now led to the development of devices which can also measure the levels of carbon dioxide at the skin level. The pulse oximeter had been of a tremendous advance in medicine and serves as a vital tool for monitoring the oxygen status of an individual. The cost of pulse Oximetry device is variable depending on the type one wants. The price ranges from $170-$950

For more on pulse Oximeters, visit www.medexsupply.com

Pulse Oximeters : Part 1

What is Oximetry?

Oximetry is a simple non invasive medical procedure used to measure the concentration of oxygen in the blood. Oximetry is widely used in the hospital care setting to assess patients who have a variety of lung and heart disorders. The measurement of oxygen is done by an oximeter which is a photoelectric device. The majority of Oximeters are small, portable and reusable. Many home devices can be run on batteries.

Where is a pulse oximeter placed on the body?

The oximeter can be placed on the finger tip, ear lobe or toes. Pulse Oximeters are so called because they react only to pulsations of the blood vessels. If there is no pulse, Oximeters will not pick up the pulsations and oxygen concentration cannot be obtained.

Pulse Oximeters are used in all intensive care units, the neonatal unit, coronary care unit, emergency room and during anesthesia. Portable Oximeters are now widely used on the regular medical floors in hospitals across America. The majority of patients who have emphysema, COPD or congestive heart failure are monitored by pulse Oximetry in the hospital.

How does a pulse oximeter work?

The pulse Oximeters work by transmitting a beam of red and infrared light though a pulsating blood vessel. The ratio of red to infra red blood light transmitted provides a measure of the oxygen saturation of the blood. The oximeter identifies the pulse and then deducts the intensity of color perceived when the pulse is absent. The residual intensity of color corresponds to only the oxygenated red blood. This is shown on the electronic screen as a percentage of oxygen saturation in the blood.

Urine strips for making Diagnosis: Part 3

Urobilinogen test does provide a clue in patient with hemolytic disorders, live failure, poisoning, resolving hematoma or hepatitis. Sometimes low values may occur when there is failure to produce bile or there is an obstruction for passage of bile. A negative result does not mean there is absence of Urobilinogen. High concentrations of ascorbic acid or sulphonamides can also obscure the color and lead to a false negative test.

The nitrite test pad gives an indirect indication of presence of bacteria. When the pad goes pink it signifies a positive reaction. Abnormal nitrite values may indicate presence of a UTI (usually from gram negative bacteria). While the test is accurate in most cases, false negatives may result if there is ascorbic acid present. To confirm present of a urinary tract infection, send a specimen for bacterial culture. Excessive urination or use of diuretic drugs can often create a false negative test due to dilution. The urine test for nitrite is most accurate when antibiotics have been discontinued for at least 3 days prior to the test

Ketones in urine can readily be identified on a urine strip. Ketones are produced in the body when fat is broken down to generate energy. Ketones are generally seen in

- Diabetic ketoacidosis
- Insulin over dose
- Starvation
- Persistent nausea and vomiting
- Strict dieting
- Stress
- Infections.

When Ketones are detected in urine, the next step is to measure urine glucose. If glucose levels are low, one should immediately seek medical attention.

The urine strip is the most inexpensive method to detect white cells in the urine. While a few cells are always present in urine, more than 20 WBC/ul is considered pathological. WBC in the urine may occur from

- Urinary tract infection
- Kidney abscess
- Bladder infection
- Infected kidney stone

The intensity of the color formed is generally proportional to the number of WBC. Results of the test can be obscured by presence of oxalic acid or oxidizing agents. Other factors that affect the test include high sugar, high protein and presence of certain antibiotics like tetracyclines and cephalosporins.

The urine strip allows at least ten quick clinical measurements in an inexpensive way. The results can then be used to treat or counsel patients for further treatment. To view our urine test kit and prices, please visit www.medexsupply.com

Urine strips for making Diagnosis: Part 2

Urine glucose is the most frequent diagnosis sought out on a urine strip. Urine strips readily identify glucose in the urine; however, for the result to be reliable one has to ensure that the strip has not expired. If the enzymatic action of enzymes is altered on the pad, then the results may be spurious.

Urine strips are quite sensitive to glucose in the urine and this is one of the fastest and inexpensive ways to check for glucose. Abnormal glucose may be seen in diabetes, pregnancy or after a heavy diet. The sensitivity of urine strip to glucose is decreased when the urine has high specific gravity or ascorbic acid concentration is high

Bilirubin levels on a urine strip are often unreliable. The best way to use urinary bilirubin level is to correlate them with clinical findings and laboratories values.

The occult blood test on a urine strip may detect red blood cells, free hemoglobin or myoglobin. The test is very sensitive and quite useful. Blood may be seen in the urine due to a kidney stone, urinary tract infection, break down of muscle, or red blood cells. When urine has high specific gravity it reduces sensitivity of the strip, while ascorbic acid may cause a falsely negative test.

The protein test pad only gives a rough estimate of protein in the urine. However, false positives may occur if the urine pH is very alkaline. Protein may occur in urine from a variety of conditions including:

- Position
- Strenuous exercise
- Extremes of temperature (too hot or too cold)
- Pregnancy
- Low blood pressure
- Liver cirrhoses
- Renal failure
- Upper respiratory tract infection
- Immune complex disorders
- Sepsis

The urine strip reagent is highly sensitive to albumin and less to globulin

Urine strips for making Diagnosis: Part 1

Urine strips are widely used in medicine to make a quick diagnosis of numerous medical disorders. The majority of these diagnostic reagent strips are designed only for human use and provide immediate useful information about health. Urine strips are frequently used by physicians and health care professionals in emergency room, outpatient clinics, nursing homes, doctor’s office and mobile ambulatory centers. The majority of urine strips are multipurpose and readily show color changes when an abnormality is identified. Most strips have gradations of color which allows one to judge the severity of the problem. For those who are not familiar with urine strips, the following information is readily available from urine strips:

Specific Gravity: Urine specific gravity is readily obtained from a strip but it only provides a clue to change in urine density. For more accurate testing, one needs to use a calibrated refractometer.

Urine pH is the most widely used property on a urine strip. The test strips are designed to measure pH change values to within 0.5 units. For the most part, urine pH values are okay for emergency use. Abnormal pH levels may be seen in the following conditions:

Alkaline urine

- Urinary tract infection
- Consuming a vegetarian diet
- Systemic alkalosis
- Bowel obstruction- pyloric stenosis
- Excessive vomiting
- Use of alkaline drugs

Acid urine

- Gout
- Fever
- Use of drugs like phenacetin
- Uric acid stones

The test strips are most accurate for pH in the range from 5-9. However, one has to remember that false negatives can occur because the solution may run over from the highly acidic protein test pad to the urine pH pad. Thus, it is important to hold the strip horizontally when evaluating urine for pH. Whenever there is doubt about urine pH, a pH meter can be used to verify your results.