Friday, October 06, 2006

My First "Tipping" Experience

I had an interesting first experience today. One that most people will never get the opportunity to experience in their lives. I "tipped" a BE patient for the first time.

"Tipping" a patient is a nice way of saying that I inserted the tip of an enema tube into the patient's rectum and administered liquid barium sulfate into their colon. Nice huh?! I hope most of you never have to experience it.

And believe it or not the "tipping" part isn't the worst of it. In many patients the barium, and air that is added later, expands the colon and makes the patient feel like they are having horrible gas cramps. I have never had one myself, but from what the patients have been describing to me during the exam, I hope to never have to have one........or at least put off having one for many years!

BEs are often done in conjuction with or instead of a colonoscopy to look for problems in the large intestine like colon cancer, diverticula, polyps, ulcerative colitis, Crohn's disease or even appendicitis. Most of your organs are not visible on standard x-rays, so in order to visualize the colon a radiopaque material (in this case barium sulfate) is used to coat the inner lining of the large intestine and then air is injected to expand the walls so all parts of the intestine are visible on the x-ray image or under fluoro examination.

BEs are a very common exam and provide the doctors with a lot of good information about the condition of the colon.

Truthfully, I had been dreading my first experience tipping a BE patient. In school the instructors always tell horror stories about techs being pooped on by elderly patients who have not been prepped properly or of patients being unable to hold in the barium and letting loose all over the table. But so far I have not seen this and, although I am sure it happens, I don't think these problems are very common.

I guess I was most concerned with the rather intimate aspect of actually tipping the patient for the first time, but everything went well in this case. I explained to her what I was going to do and made sure she was ready before I did anything. Another tech was there to make sure I did everything correctly.

I'm actually extremely relieved that my first time is over and that it went so well. I know that they wont all go so well, but at least I can always look back and remember that my first BE tipping went smoothly.


Mary said...

The hospital I am at doesn't do many BE's. They are an emergency only situation. I guess it has to do with no local Dr's who request them.

I've only had to do one, and I studied up prior to doing it. The tech comped me on it, mainly because we only get about 5 a year, but I was able to hold it together and not mess up ;)

This kind of worries me, because at some hospitals they ARE common. If I work at a hospital that does them, I'll have to 'learn on the job' which is intimidating, but really no different than having to learn new protocols regarding exams.

I might be going to a different hospital for a month to get extra BE and surgery experience, but I'm not sure if that's actually going to happen or not.

paradise.found said...

They're not very common because endo is so prevalent. But often, endo isn't an option because of time, cost or pathology. They don't do them at my site. I wish they did because I may travel when I start working. I'd like to get the beginner jitters out of the way. It's funny how we hear horror stories about them. It sounds like your experience went smoothly.