CLINICAL SKILLS - DIGITAL RECTAL EXAMINATION

Question 1

Introduction

Answer 1

hello my name is Anjali Singh and I am a third year medical student. Please can i confirm your name, age and DOB?

Nice to meet you. Today I have been asked to do a rectal examination on you. This will involve me inserting a finger into your back passage which will help me assess the structures in and around you back passage - would that be ok?

It should not be painful but maybe a bit uncomfortable.

For this examination it will require you to be bare below the waist if that is ok and the examiner will be acting as a chaperone today if that is ok.

Please can you also lie on your side for me.

Question 2

Prepare equipment (4)

Answer 2

1. lubricant gel
2. non-sterile gloves
3. wash hands
4. tissue

Question 3

Procedure (11)

Answer 3

1. i would now ask the chaperone to uncover the patient
2. the first thing i am going to do is a general inspection
3. there are no signs of erythema, anal fissures, haemorrhoids, warts, ulcers, skin tags or prolapse
4. i am now going to insert my finger - please take deep breaths in and out for me
5. please can you squeeze on my finger - I am testing sphincter tone
6. i am now going to do a posterior sweep
7. i am feeling for the prostate
8. the prostate does not feel enlarge, is not nodulated, i can feel the median sulcus, it is not tender
9. withdraw the finger
10. wipe the faeces on the tissue - there are no signs of blood or mucus in the faeces
11. here is a tissue for you to wipe yourself. You can now dress yourself.