Administrating Flatus Tube
Definition:
Inserting a rectal tube is a nursing intervention involving the gentle placement of a flexible tube into the
rectum to facilitate the release of trapped intestinal gas, thereby relieving abdominal bloating.
Purpose:
To alleviate abdominal distention caused by gas buildup
To ease abdominal pain and discomfort
To enhance comfort, especially for post-surgical patients
To support bowel function by encouraging gas expulsion
To avert complications associated with excessive gas retention
Equipment Needed:
Prescribed rectal tube
Clean or sterile gloves
Water-soluble lubricant
Waterproof pad or absorbent under pad
Kidney basin or a basin with water (to check for bubbles)
Gauze or tissues
Soap, water, or hand sanitizer
Patient's record
Indications:
Individuals with abdominal distention from gas
Post-operative patients with sluggish bowel activity
Those with paralytic ileus or intestinal sluggishness
Bedridden patients who cannot expel gas independently
Individuals experiencing discomfort from trapped gas
Contraindications:
Recent rectal or anal surgery
Active rectal bleeding or significant hemorrhoids
Anal tears or tumors
Inflammatory bowel conditions
Suspected bowel blockage
1
,Sr no Action Rational
1 Perform hand hygiene and gather Prevents cross-contamination and ensures all
equipment (flatus tube, lubricant, necessary items are ready for a safe, efficient
waterproof pad, gloves, towel, basin with procedure
warm water, tape, drainage bag or
container, tissues, privacy screen).
2 Introduce yourself to the patient. Builds trust, reduces anxiety, and encourages
cooperation during an invasive procedure.
3
Ensures the correct patient receives the
Identify the patient using two identifiers
intervention, following hospital safety
(e.g., full name and medical record
protocols.
number).
4 Explain the procedure and its purpose (to Promotes understanding, reduces fear, and
relieve gas), then obtain verbal consent. facilitates patient cooperation for successful
gas passage.
5
Maintains patient dignity and minimizes
Provide privacy by closing the door or
embarrassment during rectal exposure.
drawing the curtain.
6 Position the patient in the left lateral Allows easiest access to the rectum, relaxes
(Sims’) position with the right knee flexed. the anal sphincter, and follows the natural
rectal angle for tube insertion.
7 Place a waterproof pad under the patient’s Protects bed linen from leakage and maintains
buttocks and drape appropriately. modesty.
8 Inspect the perianal area for hemorrhoids, Prevents trauma and identifies
fissures, or skin breakdown. contraindications (e.g., recent rectal surgery,
active bleeding).
9
Reduces infection risk and protects the
Perform hand hygiene and don gloves.
healthcare worker from fecal material.
10 Lubricate 5–7 cm (2–3 inches) of the flatus Minimizes friction and pain during insertion;
tube tip with water soluble lubricant water-soluble lubricant will not damage the
tube material
11 Connect the proximal end of the flatus tube Allows passage of flatus while containing any
to a drainage bag or place the open end liquid stool; water bubbles confirm gas
into a basin partially filled with water. release.
12 Gently insert the lubricated tube 5–10 cm Follows the natural rectal curvature; insertion
(2–4 inches) into the rectum, directing it beyond 10 cm risks bowel perforation.
toward the umbilicus.
13 Observe for immediate passage of gas Confirms proper tube placement in the rectum
(bubbles in water, audible sound, or odor and effective decompression.
release).
14 Encure the tube with tape to the buttock or Prevents accidental dislodgement while
upper thigh if leaving in place allowing continuous gas drainage.
15
Allows adequate time for gas expulsion;
Leave the tube in place for 15–20 minutes
repositioning can shift bowel gas toward the
(or as ordered), repositioning the patient
tube.
gently if needed.
2
, 16 Remove the tube slowly and wipe the Prevents mucosal trauma and removes
perianal area clean. lubricant/residue for patient comfort.
17 Observe and record the amount, color, Provides clinical data on bowel function and
odor, and consistency of any stool passed, the effectiveness of gas evacuation.
plus flatus volume.
18 Remove gloves and perform hand hygiene. Prevents transmission of microorganisms.
19 Document the procedure including date, Ensures legal record, continuity of care, and
time, patient tolerance, output, and any communication among the healthcare team.
complications
Performed Checklist
Sr no Action E=5 VS=4 S=3 NI=2 IP=1 NP=0
Perform hand hygiene and gather
equipment (flatus tube, lubricant,
1 waterproof pad, gloves, towel, basin
with warm water, tape, drainage bag
or container, tissues, privacy screen).
2 Introduce yourself to the patient.
3 Identify the patient using two
identifiers (e.g., full name and medical
record number).
4 Explain the procedure and its purpose
(to relieve gas), then obtain verbal
consent.
5 Provide privacy by closing the door or
drawing the curtain.
6 Position the patient in the left lateral
(Sims’) position with the right knee
flexed.
7 Place a waterproof pad under the
patient’s buttocks and drape
appropriately.
8 Inspect the perianal area for
hemorrhoids, fissures, or skin
breakdown.
9 Perform hand hygiene and don gloves.
10 Lubricate 5–7 cm (2–3 inches) of the
flatus tube tip with water soluble
lubricant
11 Connect the proximal end of the flatus
tube to a drainage bag or place the
open end into a basin partially filled
with water.
12 Gently insert the lubricated tube 5–10
cm (2–4 inches) into the rectum,
3
, directing it toward the umbilicus.
13 Observe for immediate passage of gas
(bubbles in water, audible sound, or
odor release).
14 Ensure the tube with tape to the
buttock or upper thigh if leaving in
place
15 Leave the tube in place for 15–20
minutes (or as ordered), repositioning
the patient gently if needed.
16 Remove the tube slowly and wipe the
perianal area clean.
17 Observe and record the amount,
color, odor, and consistency of any
stool passed, plus flatus volume.
18 Remove gloves and perform hand
hygiene.
19 Document the procedure including
date, time, patient tolerance, output,
and any complications
E (5) Excellent
VS (4) Very Satisfied
S (3) Satisfied
NI (2) Need Improvement
IP (1) Incorrectly Performed
NP (0) Not Performed
Instructor’s Remarks
Date: Total Grade:
Instructor’s Signature: Student’s Signature:
4
Definition:
Inserting a rectal tube is a nursing intervention involving the gentle placement of a flexible tube into the
rectum to facilitate the release of trapped intestinal gas, thereby relieving abdominal bloating.
Purpose:
To alleviate abdominal distention caused by gas buildup
To ease abdominal pain and discomfort
To enhance comfort, especially for post-surgical patients
To support bowel function by encouraging gas expulsion
To avert complications associated with excessive gas retention
Equipment Needed:
Prescribed rectal tube
Clean or sterile gloves
Water-soluble lubricant
Waterproof pad or absorbent under pad
Kidney basin or a basin with water (to check for bubbles)
Gauze or tissues
Soap, water, or hand sanitizer
Patient's record
Indications:
Individuals with abdominal distention from gas
Post-operative patients with sluggish bowel activity
Those with paralytic ileus or intestinal sluggishness
Bedridden patients who cannot expel gas independently
Individuals experiencing discomfort from trapped gas
Contraindications:
Recent rectal or anal surgery
Active rectal bleeding or significant hemorrhoids
Anal tears or tumors
Inflammatory bowel conditions
Suspected bowel blockage
1
,Sr no Action Rational
1 Perform hand hygiene and gather Prevents cross-contamination and ensures all
equipment (flatus tube, lubricant, necessary items are ready for a safe, efficient
waterproof pad, gloves, towel, basin with procedure
warm water, tape, drainage bag or
container, tissues, privacy screen).
2 Introduce yourself to the patient. Builds trust, reduces anxiety, and encourages
cooperation during an invasive procedure.
3
Ensures the correct patient receives the
Identify the patient using two identifiers
intervention, following hospital safety
(e.g., full name and medical record
protocols.
number).
4 Explain the procedure and its purpose (to Promotes understanding, reduces fear, and
relieve gas), then obtain verbal consent. facilitates patient cooperation for successful
gas passage.
5
Maintains patient dignity and minimizes
Provide privacy by closing the door or
embarrassment during rectal exposure.
drawing the curtain.
6 Position the patient in the left lateral Allows easiest access to the rectum, relaxes
(Sims’) position with the right knee flexed. the anal sphincter, and follows the natural
rectal angle for tube insertion.
7 Place a waterproof pad under the patient’s Protects bed linen from leakage and maintains
buttocks and drape appropriately. modesty.
8 Inspect the perianal area for hemorrhoids, Prevents trauma and identifies
fissures, or skin breakdown. contraindications (e.g., recent rectal surgery,
active bleeding).
9
Reduces infection risk and protects the
Perform hand hygiene and don gloves.
healthcare worker from fecal material.
10 Lubricate 5–7 cm (2–3 inches) of the flatus Minimizes friction and pain during insertion;
tube tip with water soluble lubricant water-soluble lubricant will not damage the
tube material
11 Connect the proximal end of the flatus tube Allows passage of flatus while containing any
to a drainage bag or place the open end liquid stool; water bubbles confirm gas
into a basin partially filled with water. release.
12 Gently insert the lubricated tube 5–10 cm Follows the natural rectal curvature; insertion
(2–4 inches) into the rectum, directing it beyond 10 cm risks bowel perforation.
toward the umbilicus.
13 Observe for immediate passage of gas Confirms proper tube placement in the rectum
(bubbles in water, audible sound, or odor and effective decompression.
release).
14 Encure the tube with tape to the buttock or Prevents accidental dislodgement while
upper thigh if leaving in place allowing continuous gas drainage.
15
Allows adequate time for gas expulsion;
Leave the tube in place for 15–20 minutes
repositioning can shift bowel gas toward the
(or as ordered), repositioning the patient
tube.
gently if needed.
2
, 16 Remove the tube slowly and wipe the Prevents mucosal trauma and removes
perianal area clean. lubricant/residue for patient comfort.
17 Observe and record the amount, color, Provides clinical data on bowel function and
odor, and consistency of any stool passed, the effectiveness of gas evacuation.
plus flatus volume.
18 Remove gloves and perform hand hygiene. Prevents transmission of microorganisms.
19 Document the procedure including date, Ensures legal record, continuity of care, and
time, patient tolerance, output, and any communication among the healthcare team.
complications
Performed Checklist
Sr no Action E=5 VS=4 S=3 NI=2 IP=1 NP=0
Perform hand hygiene and gather
equipment (flatus tube, lubricant,
1 waterproof pad, gloves, towel, basin
with warm water, tape, drainage bag
or container, tissues, privacy screen).
2 Introduce yourself to the patient.
3 Identify the patient using two
identifiers (e.g., full name and medical
record number).
4 Explain the procedure and its purpose
(to relieve gas), then obtain verbal
consent.
5 Provide privacy by closing the door or
drawing the curtain.
6 Position the patient in the left lateral
(Sims’) position with the right knee
flexed.
7 Place a waterproof pad under the
patient’s buttocks and drape
appropriately.
8 Inspect the perianal area for
hemorrhoids, fissures, or skin
breakdown.
9 Perform hand hygiene and don gloves.
10 Lubricate 5–7 cm (2–3 inches) of the
flatus tube tip with water soluble
lubricant
11 Connect the proximal end of the flatus
tube to a drainage bag or place the
open end into a basin partially filled
with water.
12 Gently insert the lubricated tube 5–10
cm (2–4 inches) into the rectum,
3
, directing it toward the umbilicus.
13 Observe for immediate passage of gas
(bubbles in water, audible sound, or
odor release).
14 Ensure the tube with tape to the
buttock or upper thigh if leaving in
place
15 Leave the tube in place for 15–20
minutes (or as ordered), repositioning
the patient gently if needed.
16 Remove the tube slowly and wipe the
perianal area clean.
17 Observe and record the amount,
color, odor, and consistency of any
stool passed, plus flatus volume.
18 Remove gloves and perform hand
hygiene.
19 Document the procedure including
date, time, patient tolerance, output,
and any complications
E (5) Excellent
VS (4) Very Satisfied
S (3) Satisfied
NI (2) Need Improvement
IP (1) Incorrectly Performed
NP (0) Not Performed
Instructor’s Remarks
Date: Total Grade:
Instructor’s Signature: Student’s Signature:
4
