Competency information
Details
Undertake each investigation.
Considerations
- Standard operating procedures (SOPs) for each investigation.
- Preparation, including application of local anaesthesia.
For anorectal manometry
- Correct positioning of the catheter to obtain the optimum pressures along the length of the sphincter complex and rectum.
- The range of parameters required to give a detailed assessment of the function of the anal canal.
- Possible further tests required, e.g. recto-anal inhibitory reflex (RAIR), rectal compliance to evaluate the patient’s defaecatory disorder or faecal incontinence.
- Control settings required to optimise the collection of accurate, clear and clinically useful data.
- Possible modifications to the catheter position required during the recording, according to the patient characteristics, clinical problem, and findings.
- Artefacts and how to eliminate or minimise and annotate.
- Correct annotation of the recording.
- Safe monitoring of vital signs (including electrocardiogram [ECG] and blood pressure where appropriate) and procedures for managing medical emergencies.
- Procedure for safe removal of catheter/ultrasound probe from the anal canal.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 | Outcome Continue to perform and produce reports on non-invasive breath tests (hydrogen, methane – if there is a methane analyser available – and urea breath testing). |
| # 2 | Outcome Perform rectal digital examination to ensure safe rectal intubation with manometric and ultrasound equipment. |
| # 3 | Outcome Perform anorectal manometry procedures in patients presenting with a range of conditions, for example obstetric trauma, pre- and post-surgical defaecatory problems, slow transit constipation, obstructive defaecation, neurological disorders. |
| # 4 | Outcome Perform endoanal ultrasound investigations in patients presenting with a range of conditions, including obstetric and surgical trauma, sepsis, fissures, faecal incontinence and obstructive defaecation. |