A rectal tube, often called a Fecal Management System (FMS), is a temporary catheter inserted into the rectum to divert liquid or semi-liquid stool away from the patient’s skin. This device is primarily used for individuals with severe, uncontrollable diarrhea to protect the perianal skin from breakdown and reduce the risk of infection. The system consists of an internal retention balloon, a catheter line, and an external collection bag, which requires routine emptying to maintain functionality and patient comfort.
Preparing for the Procedure
Before beginning the process, gather all necessary supplies to ensure a smooth and hygienic procedure. You will need a clean, calibrated container to collect and measure the output, a nearby toilet or designated disposal area, disposable paper towels or wipes, and fresh disposable gloves. Strict hand hygiene is the first step, requiring a thorough washing with soap and water before donning clean gloves to minimize the transfer of microorganisms.
Ensure the patient’s privacy and comfort. The collection bag must always be positioned below the level of the patient to ensure continuous drainage by gravity and prevent the backflow of contents into the rectum. This preparation sequence is a fundamental aspect of infection control, protecting both the patient and the caregiver from potential contamination.
The Drainage Process
The procedure involves the controlled and sanitary release of contents from the collection bag into a measuring vessel. Begin by positioning the clean collection container directly beneath the drainage port, which is typically found at the bottom of the bag. The container should be placed securely on a stable surface or held by the caregiver to prevent accidental spillage.
The drainage port is usually secured with a slide clamp or a twist valve, which must be opened carefully to control the flow rate. Slowly open the clamp or valve, allowing the liquid stool to drain entirely into the container. It is imperative that the tip of the drainage spout never comes into contact with the measuring container, the floor, or any other surface, as this would contaminate the port and introduce bacteria into the system.
Once the bag is completely empty, the clamp or valve must be closed immediately and securely to prevent any leakage or accidental opening. The secure closure prevents the re-entry of air or external contaminants into the system, which could compromise the integrity of the closed drainage circuit.
Maintaining Hygiene After Emptying
Immediately following the drainage, attention must turn to cleaning the equipment and documenting the output. Using a clean, disposable wipe or paper towel, gently wipe the exterior of the drain spout to remove any residual fecal matter. This step is a direct extension of infection control, reducing the risk of odor and microbial growth on the external components.
If the patient’s care plan requires strict input and output tracking, the collected volume must be accurately measured and recorded along with the time. The contents should then be safely disposed of into the toilet or other designated waste area, and the measuring container should be cleaned according to facility or manufacturer guidelines. Finally, the soiled gloves must be carefully removed and disposed of, followed by another thorough hand washing to complete the hygiene protocol.
When to Contact a Healthcare Provider
Several signs indicate a potential complication with the rectal tube that requires prompt medical attention. A healthcare provider should be contacted immediately if there is a complete absence of output for several hours, which may suggest a blockage within the catheter line, even if the patient has had recent stool production. Blockage can be caused by solid stool particles or kinks in the tubing, leading to abdominal discomfort or distension.
Other concerning signs include any leakage of stool around the catheter insertion site, which could indicate a displacement of the internal balloon or significant skin irritation and breakdown. Fever, chills, or persistent rectal pain are also serious indicators of a possible infection or pressure injury and warrant immediate assessment.