By Dr Joe
Rectal rehydration is something not talked about these modern times and probably for good reason. The main reason being that superior access points to rehydrate a victim are readily available and much preferred.
But what about those situations where you are stuck in your sojourn in the wild and you need fluid…
…and the only fluid available is not suitable to drink orally.
Or those situations where the fluid is suitable but your fellow survivalist is unconscious for whatever reason but needs fluid urgently.
Hello, rectal rehydration. Rectal rehydration may just be the rescue you need.
I love survivalists. They thrill me. What I even love more about them is their ingenuity. Their ability to think on their feet and get creative in a flash.
To be a survivalist, and a successful one at that, you have to have a mind that works at the speed of light. Otherwise you are toast. Planning ahead is a very good strategy that will enhance your ability to survive in the wild, in the sea, in the Australian outbacks, in the frozen poles of the earth or wherever else your journey takes you…
…but what you cannot do is plan for every eventuality as a true survivalist.
Bear Grylls is a true survivalist and I love watching his exploits on our TV screens. So it was when towards the end of March this year, I turned on my TV flicking through the channels and boom, there was a survival program right there on my screen.
Ah it’s Bear Grylls. What’s he up to now? I asked myself. Well, Bear had taken a group of celebrities into the jungle somewhere in the tropics and was subjecting them to different levels of challenges every day.
As the days rolled by, Bear was eliminating the celebrities, sending them home, one at a time after judging their level of coping with each challenge.
More or less eliminating and sending home the weakest link, if you like. Remember the ‘Weakest Link’ TV program? Anne Robinson, where are you?
Each celebrity eliminated usually feels disappointed and you could feel and see the disappointment on their faces when they face the camera for the last time following their eviction.
Even though there’s no real prize to be won by the ultimate winner, I suppose everyone still wants to win in the end. The adventure is a life challenge and anyone with a modicum of competitiveness would want to win.
Winning gives you a sense of achievement, something to put on your Life Resume, something to point to in future, a conversational starter and a thing to support your strength of character argument.
The flip side is, eviction from a challenge like that is seen as failure by the evictee and along with it also comes a sense of rejection too. Not many people deal with rejections very well.
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Anyway, back to what was happening in this very Bear Grylls TV episode. Bear gathers the remaining 4 celebrity contestants together and talks about a survival strategy. This survival strategy is sort of historical. Old medicine. Not used any longer but could come in handy when you are stranded, dehydrated and no clean water available for you to drink orally.
But you have access to some water that is not so clean, shall we say. How do you get to “drink” this water that your body so desperately needs?
Yep, you guessed it – Rectal Rehydration.
It’s about using an alternative route of entry to rehydrate your body using fluids that would otherwise not be suitable for drinking by mouth. It’s nice to have an alternative entry point. You never know when you will need it!
Even the Northampton General Hospital Family Planning Clinic in England is unwittingly providing alternative entry as “family planning advice”. Apt or what.
Now a word of advice: You should not use sea water for rectal rehydration. It is dangerous!
Bear Grylls gives a little talk about rectal rehydration in survival circumstances, strips in front of the celebrities butt naked (shock horror), lies down, eventually covers his modesty and up comes his colleague to pop in the Camelbak rehydration tube and Bear gets his rectal rehydration done in a flash.
The reaction on the celebrities’ faces was a joy to behold on two occasions. The first was when Bear stripped right in front of them. They were not expecting a strip tease and so didn’t know where to look.
The second was when he turned to them saying it was their turn to get rectally rehydrated next. They weren’t expecting that either. Go on, watch the clip below and have a laugh.
After all said and done, rectal rehydration is a serious interventional therapy that can save lives. It might just save yours if you find yourself in precarious situations. Yes, oral rehydration and intravenous therapy are better routes to get an individual hydrated to save a life or lives.
But sterile intravenous fluids or safe oral rehydration fluids may not always be available in survival situations, hence having an alternative form of hydration to hand is never a bad thing. Call rectal rehydration a backup plan if you will.
What is Rectal Rehydration?
As the name implies, rectal rehydration is the process of administering fluid or indeed medicine through the back passage i.e the rectum using a suitable apparatus in conditions where intravenous, oral or subcutaneous administration are not ideal or not possible.
Rectal rehydration was first described by Wisconsin Surgeon, John Benjamin Murphy in 1909. This technique was employed as a first aid treatment on the frontline in the World War 1.
Rectal rehydration was common place practice before it got swept aside by intravenous method ofrehydration and drug administration.
Rectal rehydration is also referred to as proctoclysis or rectoclysis. The procedure is synonymous with enema administration, although in this case you are not expecting anything to be “returned” unlike enema situation.
When would you need rectal rehydration?
The short answer is when oral or intravenous fluid administration is not possible and this could be due to a variety of reasons.
The beauty of rectal rehydration is that you do not need any medical training to do it. Absolutely anyone with commonsense can carry out this procedure to save a life of a relative, a friend, a fellow survivalist or even yourself.
What will you do if you have someone with you in the Australian outback, in some dessert somewhere or some forest in the middle of nowhere, who has become unwell and has any of the following:
- Has nausea and therefore drinking orally is out of the equation
- Has become unconscious – you can’t be giving an unconscious person something to drink, can you?
- Is in shock – not ideal to give oral fluids in a shocked individual. Works in shock situations as proven in this research article.
- Or as demonstrated by Bear Grylls there is water available but not suitable to drink orally.
Using this rectal alternative route in these circumstances could be life-saving. Therefore it’s good to know how to do rectal rehydration. It’s an easy to learn skill that could be useful in these situations.
For instance, here is a case report by Michael Grocott who saved the life of a 21-year-old young Nepalese man during a crossing of the Mera La in the Solu-Khumbu district, Nepal.
This man who had been vomiting blood all day was kept alive by rectal rehydration until medical help came more than 24 hours later.
We have established you don’t need any medical training to do rectal rehydration. Even better you can use makeshift equipment to do the job if need be. Yes, there is the Camelbak toolkit but what if you don’t have the ideal kit? You can always make your equipment up with a little creativity.
In that case report, Michael and his colleagues used a Foley’s catheter and a glove with one of the fingers of the glove cut off, and taped securely to the catheter.
As Mike Reed demonstrates below, your creativity can take you places. You can actually self-administer fluid on yourself if you find yourself alone and you are nauseous or you run out of water but you need water…
…and the only available water is not exactly fit for drinking. You will have to adapt and give yourself the only available fluid via your rectum (your back passage). Watch Mike’s demonstration below:
Are you now convinced self-use of rectal rehydration is actually possible?
So what do need to carry out rectal rehydration?
Not a lot really.
To successfully carry out rectal rehydration, you need the following basic necessities:
==> A water reservoir of sorts. Camelbak rehydration kit is a very popular brand used and trusted by keen survivalists. Available here on Amazon.com and here on Amazon.co.uk. Here is a cheaper brand on Amazon.com if you fancy another.
==> Fluid – preferably clean water but use whatever water is available just so long as it is not sea water. If you have oral rehydration solution all the better. The glucose and the sodium in oral rehydration solution are a perfect mix for optimum absorption. The glucose helps the sodium ion to absorb the water across the large bowel’s mucous membranes.
==> Some sort of lubricant preferably water based like KY Jelly
==> A tape to secure the tubing if available
==> Clothing to cover the victim
How to do rectal rehydration – Step by Step?
Probably one of the simplest things you can perform on a victim or yourself to save a life until help professional help arrives.
Here are the few easy steps to successfully perform rectal rehydration on someone else.
Step 1. You will need the victim’s bum exposed for access, so clothing needs to be pulled down to mid-thigh level.
Step 2. Lie the victim on his/her left side. This helps fluid to stream into the bowel segment we call the sigmoid colon easily. That pooling of the fluid in the sigmoid colon will help the onward flow upstream.
Step 3. Wash your hands and don a pair of gloves if available (after drying your hands, otherwise you will struggle to get the gloves on properly).
Step 4. Add a lubricant to the end of the end of the tube that will be inserted into the bum hole. Try not use too much lubricant as this could be counter-productive. You don’t want the tube sliding too far inside the rectum and you also don’t want it sliding out unintentionally.
Step 5. If the mouth piece of the drinking tube is detachable, then go ahead and detach the mouth piece. If it isn’t, then use a knife to cut it off. You will now have to plug the end of the tube with your finger to avoid spilling and losing the fluid you intend to rehydrate the victim with.
Step 6. Now insert the mouth piece end of the tube into the victim’s bum hole. An insertion length of about 15cm is just good enough. Insert gently though. You will feel an initial resistance because of the victim’s anal sphincter but once you get past the sphincter you should be fine. The tube will glide in easily.
Step 7. If you have a tape, secure the tube in place by taping the tube to the victim’s bum on both sides. This will prevent the tube slipping out accidentally.
Step 8. Cover the victim up both for dignity and to prevent hypothermia.
Step 9. Now hang the reservoir onto a tree branch or anything to give it some height. Having the fluid bag (the reservoir) in an elevated position helps the fluid to drip into the rectum aided by gravity.
Once you have hung the bag, just leave it alone and let it do its thing. Do not attempt to rush the rate of flow. Just let gravity take over. The victim will thank you for it.
That’s it, folks. See it wasn’t hard, was it?
Now you have a backup plan when you go hiking, trekking, cycling, mountaineering, biking, undertaking those deep expeditions into the middle of nowhere, the outbacks, the rain forest, the deserts, the tropical jungle where potentially you could be in need of rectal rehydration. You just never know!
One last thing. If you are a survivalist or a prepper, you may be interested in making ultimate survival foods. You should be actually. Possessing this skill is another “weapon” to have in your tool kit. Now, here’s one question that should bother you. How do you make superfoods that last a lifetime without refrigeration? Yes, you can. But how? Go here to find out how
Dr. Joe