Position the patient (lithotomy position or left lateral decubitus w/ knees flexed toward chest)
Pull buttock apart, inspect the external area
Perform digital rectal exam with lubricated, gloved finger (use topical anesthetic jelly if needed and wait 1-2 minutes prior to<unk> 
Lubricate the<unk>  and the central guide plug (obturator)
Slowly insert the<unk>  fully, maintaining pressure on the obturator.
If obturator slips or falls out during insertion, remove<unk>  completely and repeat procedure
Once inserted, remove the obturator (keep it nearby if needed again)
Slowly withdraw, rotate (if non-slotted<unk> , and visual the entire circumference of the canal
Perform any biopsies (if above dentate line) or cultures as needed
If obturator slips or falls out during insertion, remove<unk>  completely and repeat procedure
Anoscopy
Perianal block
FAST exam
Loperamide
Gastric lavage
Misoprostol
Emergency contraception
GI antibiotics