Digital Rectal Examination

Question 1

How would you explain the exam?

Answer 1

I need to perform a rectal examination, this will involve me inserting a finger into your back passage. It will be a little uncomfortable, but shouldn’t be painful and will only last a short time.

Question 2

What equipment do you need?

Answer 2

Gloves
Apron
Lubricant
Paper Towels

Question 3

What preparation do you need to do before the exam?

Answer 3

Wash hands, apron and gloves on
Expose - remove underwear (give them a blanket), leave the room to allow them to do it
Position - left lateral, with knees to chest

Question 4

What are you looking for in inspection?

Answer 4

Pull the cheeks apart
Skin excoriation
Skin tags
Rashes
Haemorrhoids
Anal fissures (described like a clock face)
External bleeding
Fistulae/abscesses

Question 5

What is the process of palpation?

Answer 5

Lubricate the examining finger
Warning
Insert finger facing posteriorly
Ask to squeeze
Feel the posterior and lateral walls
Feel the anterior wall (prostate and cervix)
Ensure felt 360degs
Withdraw finger - look for blood/melaena, stool/mucous
Clean patient