Rectal Hydration (or getting fluid in other holes)

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Rectal Hydration (or getting fluid in other holes)

Post by Ovationman » Tue Aug 02, 2011 10:13 pm

After many threads on IV fluid resuscitation, I think alternative should be considered. Most people do not have the training for or the access to IV fluids. Having another means of hydration could be life saving, away from traditional medical care. Although there is a dearth of clinical information on the subject, I did find this journal article.

"Resuscitation From Hemorrhagic Shock Using Rectally
Administered Fluids in a Wilderness Environment
Michael P. W. Grocott, BSc, MBBS, MRCP, FRCA; Stuart McCorkell, BSc, MBBS, FRCA;
Mark L. Cox, BSc, MBBS, FRCA"

"We report the successful use in a wilderness environment of rectally administered oral rehydation
fluid to resuscitate a patient who was in shock. The subject was a 21-year-old Nepali man who had
experienced a major upper gastrointestinal hemorrhage"
http://www.fileden.com/files/2010/4/15/ ... onment.pdf" onclick="window.open(this.href);return false;

(not wilderness/disaster context but still interesting)
"on-Oral Hydration Techniques in Palliative Care
Robin Fainsinger MD"
http://www.eperc.mcw.edu/fastFact/ff_134.htm" onclick="window.open(this.href);return false;

Rectal fluids are sub-optimal in just about every way. They still could provide the only course of treatment in some cases.
Last edited by Ovationman on Tue Aug 02, 2011 10:56 pm, edited 1 time in total.

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Re: Rectal Hydration (or getting fluid in other holes)

Post by doitnstyle1 » Tue Aug 02, 2011 10:35 pm

Yup! it works. I have unfortunately had the pleasure of doing it a couple of times in an emergent field situation (not on myself but with patients) it works quite well.
Lowers the core temp if overheating absorbs rather quickly through the colon and lets you hit a vein much easier if the veins are collapsed.
Make sure you wear gloves and make you you are prepared for a blowout afterward. in other words don't stand in the line of fire. :lol: you might just get a little more than egg on your face.
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Re: Rectal Hydration (or getting fluid in other holes)

Post by Dawgboy » Tue Aug 02, 2011 10:49 pm

Sounds like "fun"... :lol:
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Re: Rectal Hydration (or getting fluid in other holes)

Post by 72hours » Tue Aug 02, 2011 11:18 pm

"Fun"?
Depends on if you're the pitcher or the catcher I suppose.....
Even then, we really need to work on your definition of fun Dawg.....

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Re: Rectal Hydration (or getting fluid in other holes)

Post by Dawgboy » Tue Aug 02, 2011 11:30 pm

Yeah... too late in the day to remember the code for blue text...
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Re: Rectal Hydration (or getting fluid in other holes)

Post by Confucius » Tue Aug 02, 2011 11:37 pm

http://zombiehunters.org/forum/viewtopi ... 43&t=79200" onclick="window.open(this.href);return false;



ZS is starting to scare me a little bit, we have so much information that we've come back around to rectal rehydration.

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Re: Rectal Hydration (or getting fluid in other holes)

Post by 72hours » Wed Aug 03, 2011 12:33 am

Could be worse....
Had a lecture the other day on the advancements we've made in CPR/First Aid.
In the 1700's they would fill an animal bladder with smoke and blow it up a person's rectum as a form of resuscitation.....
I wonder what the success rate was with that?

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Re: Rectal Hydration (or getting fluid in other holes)

Post by Oneswunk » Wed Aug 03, 2011 12:41 am

72hours wrote:Could be worse....
Had a lecture the other day on the advancements we've made in CPR/First Aid.
In the 1700's they would fill an animal bladder with smoke and blow it up a person's rectum as a form of resuscitation.....
I wonder what the success rate was with that?
Now your just blowing smoke up my ass.


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Re: Rectal Hydration (or getting fluid in other holes)

Post by KnightoftheRoc » Wed Aug 03, 2011 3:27 am

72hours wrote:Could be worse....
Had a lecture the other day on the advancements we've made in CPR/First Aid.
In the 1700's they would fill an animal bladder with smoke and blow it up a person's rectum as a form of resuscitation.....
I wonder what the success rate was with that?
I'm thinking they had one success. Just the one, and that was probably the first try. Amazing, how during the "Age of Reason", the most UN-reasonable things caught on as "proven fact", like bleeding a patient being somehow beneficial to them. Makes you wonder how anyone survived long enough to have the next generation.
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Re: Rectal Hydration (or getting fluid in other holes)

Post by Dave_M » Wed Aug 03, 2011 4:07 am

KnightoftheRoc wrote:
72hours wrote:Could be worse....
Had a lecture the other day on the advancements we've made in CPR/First Aid.
In the 1700's they would fill an animal bladder with smoke and blow it up a person's rectum as a form of resuscitation.....
I wonder what the success rate was with that?
I'm thinking they had one success. Just the one, and that was probably the first try. Amazing, how during the "Age of Reason", the most UN-reasonable things caught on as "proven fact", like bleeding a patient being somehow beneficial to them. Makes you wonder how anyone survived long enough to have the next generation.
Actually, given the knowledge of their day, bloodletting patients was thoughtful and cognizant. Think about it for a minute; it's actually quite reasonable.
-Patient has a fever. Obviously they have too much blood.
-Do some bloodletting. Very quickly two things happen:
1) Body core temperature reduced
2) Skin goes from bright red to cold and clammy

-Proof!!

So, in some instances, it made perfect sense to them that it worked for some situations. Now, they were completely wrong but that doesn't make it, 'stupid'. I'm sure in one hundred years people are going to look at us like barbarians and say, "They used to cut out cancer?!? Were they fucking stupid?!?"

Just offering some perspective :wink:
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Re: Rectal Hydration (or getting fluid in other holes)

Post by Liff » Wed Aug 03, 2011 7:01 am

Since this is a duplicate thread, lets continue with the off topic....

Present tense, we look at what physicians did in the 1950's and laugh as though they were barbarians.

We, the medical community, used to treat blood pressure with alpha blockers. Short version: Alpha blockers will lower the blood pressure and the patient will die just as fast as if the blood pressure was left alone.

We used to treat mild depression with ritalin. For reals. http://scienceblogs.com/neurophilosophy ... lin_ad.php" onclick="window.open(this.href);return false;

We used to think that Vytorin actually worked. It does lower cholesterol, but it does not improve patient outcomes.

So for sure, in 2050, the medical community will be looking at some things we are doing now and shake their heads like we are shaking our heads now. Probably sooner.

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Re: Rectal Hydration (or getting fluid in other holes)

Post by NoAm » Wed Aug 03, 2011 7:10 am

I guess it's great, if it works...........................................what should be added to BOB's for this?

Ohhhhhhhhhhhh it just seems SO wrong.

I can see the reactions at the next ZS meeting for the BOB show & tell :shock:
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Re: Rectal Hydration (or getting fluid in other holes)

Post by Gingerbread Man » Wed Aug 03, 2011 7:29 am

Yes, rectal hydration works very well. If the patient is unconscious and you don't have an IV bag/needles (I don't) a simple 3/8 to 1/4 rubber tube up the shoot and you'll have a hydrated patient in no time. I guess the best ad hoc tube would be the one from your camel back. Yea, trash it afterwards and get good insertion (I think about 6-8"). Likewise, to administer a medication the rectum is the fastest way to get that drug into the blood stream without an IV.

Not fun, not cool but it works. Saving lives is never pretty.
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Re: Rectal Hydration (or getting fluid in other holes)

Post by Murph » Wed Aug 03, 2011 7:38 am

NoAmnesty wrote:I guess it's great, if it works...........................................what should be added to BOB's for this?

Ohhhhhhhhhhhh it just seems SO wrong.

I can see the reactions at the next ZS meeting for the BOB show & tell :shock:

"Hmm, now was this my beer funnel, or my rectal rehydrator?"
Does your BOB at least have: water, basic tools, fire, food, first-aid kit, and shelter?
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Re: Rectal Hydration (or getting fluid in other holes)

Post by KnifeStyle » Wed Aug 03, 2011 8:45 am

Damn you, Bear Gryllis...
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Re: Rectal Hydration (or getting fluid in other holes)

Post by Gingerbread Man » Wed Aug 03, 2011 8:47 am

KnifeStyle wrote:Damn you, Bear Gryllis...
Bear didn't do it right nor did he make this up. It's been around for a long time. Bear used sea water, which is doing it wrong. It just mean shitty salt water gets into your system faster. Bear, you suck.
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Re: Rectal Hydration (or getting fluid in other holes)

Post by combat_medic » Wed Aug 03, 2011 8:57 am

We call it the Ranger IV. I've threated it a few times but never had to use it. "Doc i'm dehydrated, I need an IV 'cause I can remember to drink water." Tell them you're going to shove a tube up there ass and they remember to drink water real fast.

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Re: Rectal Hydration (or getting fluid in other holes)

Post by Medic77 » Wed Aug 03, 2011 9:29 pm

I would have to see actual evidence that rectal administration of fluids for volume replacement actually works. And by evidence I mean a study population of a few hundred people minimal. A single case report is hardly sufficient evidence to bet the house on.

Placing a large volume of water in someones rectum is going to act as an enema and stimulate a bowel movement causing additional loss of fluid. How much loss, who know's? Will there still be a net gain, who know's? But any loss is counterproductive. My second concern is hyponatremia (decreased sodium concentration). If your thinking of using "regular" water then this risk is of concern. People who drink lot's of water during periods of heat stress, marathons, etc are prone to hyponatremia and it's serious effects so rectal administration would lead me to have the same concern.

You also have to remember that regular water is hypotonic. This means that the water is going leave the vascular space much, much faster than your isotonic fluids such as normal saline and lactated ringers The water you are giving isn't going to stay in the compartment you want it which is the vascular space.. it is going to shift out of the vascular space and into the cells. Granted sometimes this is desirable but in the field the goal is to initially replace the volume lost from the vascular space. Hypotonic fluids should not be administered in large volumes quickly.

I had a 20 something male one time who was working construction (building a house) with no medical history and was very healthy who collapsed and went into cardiac arrest on a very hot day. The autopsy showed arrest due to hyponatremia. Apparently he was consuming way too much water which diluted the sodium concentration. People who "force feed" water to children as a method of abuse induce hyponatremia. Hyponatremia can cause CNS effects of lethergy, weakness, seizures, arrhythmia, and cardiac arrest.

I's curious to know how one would go about infusing this fluid into the rectum. How exactly would you plan to do this? Stick the IV tubing up the rectum and pressure infuse the fluid? Use a 60cc catheter tip syringe? Curious on ideas.
Last edited by Medic77 on Wed Aug 03, 2011 9:43 pm, edited 1 time in total.
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Re: Rectal Hydration (or getting fluid in other holes)

Post by Confucius » Wed Aug 03, 2011 9:40 pm

Medic77 wrote:I would have to see actual evidence that rectal administration of fluids for volume replacement actually works. And by evidence I mean a study population of a few hundred people minimal. A single case report is hardly sufficient evidence to bet the house on.

Placing a large volume of water in someones rectum is going to act as an enema and stimulate a bowel movement causing additional loss of fluid. How much loss, who know's? Will there still be a net gain, who know's? But any loss is counterproductive. My second concern is hyponatremia (decreased sodium concentration). If your thinking of using "regular" water then this risk is of concern. People who drink lot's of water during periods of heat stress, marathons, etc are prone to hyponatremia and it's serious effects so rectal administration would lead me to have the same concern.

I had a 20 something male one time who was working construction (building a house) with no medical history and was very healthy who collapsed and went into cardiac arrest on a very hot day. The autopsy showed arrest due to hyponatremia. Apparently he was consuming way too much water which diluted the sodium concentration. People who "force feed" water to children as a method of abuse induce hyponatremia. Hyponatremia can cause CNS effects of lethergy, weakness, seizures, arrhythmia, and cardiac arrest.

I's curious to know how one would go about infusing this fluid into the rectum. How exactly would you plan to do this? Stick the IV tubing up the rectum and pressure infuse the fluid? Use a 60cc catheter tip syringe? Curious on ideas.
http://www.ncbi.nlm.nih.gov/pubmed/9601155" onclick="window.open(this.href);return false;

Just an abstract, but answers most of those questions.

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Re: Rectal Hydration (or getting fluid in other holes)

Post by Medic77 » Wed Aug 03, 2011 10:05 pm

I took a quick glance at that and it is a small study. Nothing in medicine is based off a single, small scale study but thank you for providing the link. I do admit that proctoclysis is an interesting concept and would like to see more evidence and case report's of it's use. In the study posted and in another article I read, the rate of administration was controlled. How would you control the rate of administration in the field by an untrained person? 100-400ml/hr was stated as being safe. If you go and continuously pour water into the rectum I could foresee problems.
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Re: Rectal Hydration (or getting fluid in other holes)

Post by Drakon » Wed Aug 03, 2011 10:46 pm

so..uhm...how would someone go about administering this?

right now i''m picturing someone shoving a camelbak drinking tube 6-8" up someone elses ass, is that the gist of it? how do we control flow rates? is it a gravity feed or are we pumping it down under pressure? do i need a water pump :shock:
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Re: Rectal Hydration (or getting fluid in other holes)

Post by Medic77 » Wed Aug 03, 2011 10:57 pm

Research and actual practice of this is really limited. I think most physician's may be hard pressed to give absolute advice. This forum sparked my interest in this procedure and so I have been doing some research of my own.

It sounds like the rate of fluid need's to be controlled (seem's obvious, right). A stated safe rate was 100-400mL/hr but who know's for sure due to limited evidence and practice. A higher infusion rate could be safe but who know's. Also, most case's have used either a commercially prepared isotonic solution (saline or lactated ringers) or water with salt added to it to make the water more isotonic.

Water intoxication or hyponatremia is well documented due to tap-water enemas especially in children. So if tap-water enemas are causing these problems then how would massive amounts of plain water in an emergency situation not cause problems or carry risk?
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Re: Rectal Hydration (or getting fluid in other holes)

Post by ehunter72 » Thu Aug 04, 2011 12:38 am

An austrailian IV, you know, from "down under" (thats what I called it when threatining troops who wouldnt drink water)

ahmmm no..

maybe in the most extreme situation, but since I won't ever deploy again, I just cannot imagine ever doing it.

I would hate to write the justification for not following procedure/proticol on this to my provider or testify in court.

I can hear the defense atty, Ehunter can you tell the court where you recieved your training on anal infusion?
me on ZS of course, duh...

Its not a prehospital recomended procedure and is not taught in any class I have ever had (for certification or otherwise)

well you see I couldnt get a line going, so I placed the pt in a position with his ass up and forcibly inserted a tube in his asshole then I connected and IV to it an squeezed till it came shooting out.....
why didnt I use a Intraosseous infusion? well i wanted to try this out...I read it on ZS and it seemed lke it might work.
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Re: Rectal Hydration (or getting fluid in other holes)

Post by KnightoftheRoc » Thu Aug 04, 2011 1:39 am

Medic77 wrote:Research and actual practice of this is really limited. I think most physician's may be hard pressed to give absolute advice. This forum sparked my interest in this procedure and so I have been doing some research of my own.

It sounds like the rate of fluid need's to be controlled (seem's obvious, right). A stated safe rate was 100-400mL/hr but who know's for sure due to limited evidence and practice. A higher infusion rate could be safe but who know's. Also, most case's have used either a commercially prepared isotonic solution (saline or lactated ringers) or water with salt added to it to make the water more isotonic.

Water intoxication or hyponatremia is well documented due to tap-water enemas especially in children. So if tap-water enemas are causing these problems then how would massive amounts of plain water in an emergency situation not cause problems or carry risk?
First off, my training is as a plumber, not a doctor, so I'm no expert, and don't mean to sound like one.
But, to address these two bolded points above, I'm wondering if you were to set up a gravity fed enema type of arrangement, if that would supply the fluids in the proper amounts- I'm thinking the large intestine wall would absorb the water as it normally does, and the gravity feed would simply keep it supplied, not under pressure. Also, if you kept the amount of water being administered to an amount of 1 liter or maybe 2, couldn't you avoid the side effects of it lacking the electrolytes a good oral solution would have?
Honestly, I can't really see my ever having to implement a course of treatment like this, but knowledge is a good thing, if used properly, and, well- you never know, do you?
Also, I am with you on the wish to see some serious testing results before accepting ANY course of treatment, especially since the only people I'd be treating would be family, if at all (and I hope the need NEVER arises), and I'm not willing to take chances with my family's health, let alone their lives.

Knowing a treatment, like this one for example, is one thing- using it, is another. It's a lot like knowing where to find the appendix and a kitchen knife, versus actually removing a family member's appendix on the kitchen table. Sure, it's been DONE, but I don't see a good outcome being the most likely one.
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