Make sure the stop-flow balloon is completely deflated and the retention cuff is inflated. Gently tug and release to “seat” the retention cuff. Be sure the low-impact zone is not twisted, the anchor straps are secured, the tubing is straight and free of stool, and the drainage bag is lower than the patient. Placing the bed in a slight reverse Trendelenburg position will facilitate catheter drainage.
During irrigation, if tolerated, position the patient in a slight Trendelenburg position. Avoid infusing irrigation too rapidly or using water that is too cool. Excessive leakage during use may be secondary to catheter occlusion with stool. Catheter removal, stool removal, and reinsertion may be required. Additional stool modification or more frequent irrigation (as prescribed by physician) may be required to prevent recurrence. Regular irrigations can help prevent rectal distention, which is associated with leakage. If leakage is excessive, consider discontinuing use of the ActiFlo System.
The collection bags available with the ActiFlo System contain a film which is designed to control odor associated with stool. Other helpful hints to help control odor:
Flush the drainage tubing with tap water using the sampling/tube flushing port at least twice a day. Routinely cleanse any leakage from around the anus. If using the drainable collection bags, cleanse the exposed end of the drainable collection bag spout before capping it. Change the drainable collection bags every seven days.
In a study of 32 patients treated with this system, there were no anal mucosal abnormalities observed.1 In a separate study of 20 patients, proctoscopic exams were normal after tube removal in all cases.2 The physician prescribing the ActiFlo Indwelling Bowel Catheter System must evaluate the risks and benefits of using the device for each individual patient.
Do not use in patients having known sensitivities or allergies to the materials used in this device. Do not use if the patient’s distal rectum cannot accommodate the inflated volume of the retention cuff, or if the distal rectum/anal canal is severely strictured (e.g., secondary to tumor, inflammatory condition, radiation injury, scarring). Do not use on patients having impacted stool. Do not use on patients with a recent (less than 6 weeks old) rectal anastomosis, or a recent (less than 6 weeks old) anal or sphincter reconstruction. Do not use on patients with compromised rectal wall integrity (e.g., ischemic proctitis).
This feature allows the clinician to create a smooth tip for catheter insertion. The stop-flow balloon is the feature that permits the clinician to temporarily stop flow through the catheter so rectally administered medications can dwell in the rectum for the prescribed amount of time.
Yes, the catheter can be washed off, checked for product integrity and reinserted, according to the Instructions for Use, as long as it’s still within 29 days of the initial insertion. It is important to investigate why the device was expelled. Check for retained stool in the rectum or other problems that may have contributed to catheter expulsion and resolve these issues.