To the Editor:

Let me tell you what a godsend the technique described by Grogan and Kramer in "The Rectal Trumpet: Use of a Nasopharyngeal Airway to Contain Fecal Incontinence in Critically Ill Patients" (JWOCN 2002;29:193-201) has been for us. I am the Wound, Ostomy, Continence CNS at a long-term acute care/rehab/skilled nursing facility with an average census of 245. On our medically complex unit, we have many ventilator dependant patients (as well as others) directly from ICU/CCU who have either C diff or VRE diarrhea (or both)!!

I introduced the concept of the rectal trumpet to this unit last year after your article came out. When I returned from the WOCN conference, the nurses had taken the concept and run!! This technique has helped us attain intact perianal skin for the patients who come to us with perianal denudement and prevent skin breakdown in others.

This has also provided the most memorable moments for our nursing procedure chair who had to take this procedure to the facility-wide committee. She said everyone!!s eyes got big and they said, "the rectal what?" Of course, our respiratory therapists couldn!!t believe why we were using more nasopharyngeal airways, either: "You want to put it where?"

Thank you for your innovation!!