Vaginal irrigation or douche is the process of introduction of plain or medicated water or normal saline into vaginal cavity for cleaning purpose allowing the fluid to come out. Or in other word it can be defined as ‘Flushing out of vaginal cavity with a fluid. Now a days this procedure is commonly ordered than the past, but it may be required as part of the routine preparation of the patient for vaginal operation or for patient who have profuse or offensive vaginal discharge due to some reason or other.
- To clean and remove irritating
- To disinfect and deodorized the mucous membrane of vagina.
- To check further infection upwards to cervix and uterus.
- To relieve pain and congestion.
- To stimulate blood circulation to vaginal and adjacent pelvic organs and promote absorption of exudate.
- To promote quick healing.
- As a procedure before any surgery of vagina.
Solution used for douching
- Plain sterile water 1 Liter to 2 Liter
- Dettol 1: 60 (1 ml in 60 ml of sterile water).
- Savlon 1: 10Q0. (1 ml in 1000 ml of sterile water).
- Potassium Permanganate 1 : 5000 (1 gm in 5000 ml of sterile water).
- Sod-bicarb. 1% to 2% (1—2 gm in 100 ml of sterile water).
- Normal saline (0.9%—0.9 gm of salt in 100 ml of water and make sterile by boiling for 30 to 40 minutes.
- Lysol | to 1%,
- Iodine solution 1 cc In 100 cc of sterile water.
- Acetic acid (dilute) or table vinegar 1 cup in 1 Liter of sterile water.
- Bichloride of mercury 1 in 4000 cc of water.
The Temperature of solution
- For cleansing—I05°F 1 to 1| Ltr.
- For inflammation—110°F to 112°F 2 Ltr.
- For haemorrhage—115°F—120°F 4 Ltr.
- For all other purpose—105°F—107°F.
- A piece of mackintosh. 2. A tray. 3. Douche-can with rubber tubing and clamp. 4. Bed pan. 5. Desired solution. 6. Sterile dutch nozzle in sterile tray. 7. Sterile cotton in sterile container. 8. Sponge holding forceps. 9. Enema stand. 10. Lotion thermometer. 11. Pint measuring jug.
Being A Proper Nurse You Must Learn About Vaginal Irrigation Procedure
- Explain the procedure the patient.
- Put a bed side screen for privacy.
- Boil the douch can, tube and pint measure for 10-15 minutes after cleaning with soap and water.
- Take the solution you want to use and bring it to required temperature.
- Collect all materials on a table at bed side.
- Bring the patient to normal dorsal position lying on bed with knee flexed.
- Put the hip of the patient over the mackintosh sheet.
- Put a bed sheet or a cloth on the patient up to the knee and expose only required area.
- Put a bed pan under the patient’s buttock.
- For comfort of the patient a pad over bed pan or a pillow below the back or head may be given specially in long douching.
- Put the douch can on stand about 12 inches to 16 inches above bed. This height is preferred as to reduce the flow and force of fluid.
- Wash your hand with soap and water.
- Clamp regulator or screw clip to put on the tube to control flow.
- Allow a small amount of solution to flow down the vulva.
- Clean the vulva with sterile swab by mean of sponge holding forceps.
- With left hand open the labia and allow the stream of solution to flow over vaginal opening.
- Now attach the sterile douche nozzle to the tubing and clamp it.
- Open the labia again and introduce the nozzle upwards and backwards gently.
- Release the screw clamp and allow the solution to run down.
- When the solution is finished, remove the nozzle and clamp it on stand.
- Allow the patient to remain on bed pan to complete drainage of solution. For this slide may be allowed to sit if she can sit or asked to cough to put pressure on abdomen to allow complete drainage.
- By means of dry swab, dry the vulvar area.
- Remove bed pan.
- Put a sterile pad if patient already had it and tie ‘T* bandage.
- Ask the patient to lie down for hour after vaginal douching.
- Observe and note the character if washed out fluid in bed pan.
- Clean all equipment used.
- Record the procedure in chart.
Points to remember for vaginal douching
- Give a douche only when a doctor advice for it and not when the patient asks for it.
- Douche should be avoided during menstrual period.
- Douche should be avoided during pregnancy unless specifically advised by doctor.
- Douche is usually not given to young virgin girls.
- Always test the temperature of douche solution before introducing either by lotion thermometer or by dorsum of your hand.
Other types of vaginal douche
- Long hot douche.
- Intra uterine douche.
- Low pressure douche.
Long hot douche
- This is used to provide heat to pelvic organ or for cleaning purpose.
- The temperature of solution is maintained between 110°F to 120°JF.
- The procedure is continued for 15-20 minutes.
- The other procedures are same as that of common vaginal douche.
Intra uterine douche
This was used earlier and now a-days this procedure has been abandoned to its dangers.
Low pressure douche
This is the same vaginal douche, the difference being the low height of irrigation can (douche) to allow the flow of fluid with low pressure. The douche can be put at a height less than 12 inches. The aim of such low pressure douche is to prevent entry of any vaginal materials upwards to cervix or uterus.