16: Tubes and drains

Question 1

How much of the GI tract should you try to use?

Answer 1

As much as possible

Question 2

How often should you weight the patient?

Answer 2

Daily

Question 3

Which species usually gets an NG tube?

Answer 3

Cats

Question 4

What are disadvantages of NG tube?

Answer 4

Small diameter, can only have for one week

Question 5

How do you verify NG tube placement?

Answer 5

Vacuum, well tolerated water injection

Question 6

How often should you re-check NG placement?

Answer 6

Before every feed

Question 7

How do you secure an NG tube?

Answer 7

Glue, staples, suture

Question 8

What are three advantages of oesophagostomy tube?

Answer 8

Better for long term home care, won’t cause peritonitis, patients can eat around it

Question 9

What are two disadvantages of oesophagostomy tube?

Answer 9

Can’t use if vomiting, requires GA, food can leak into peri-oesophageal tissues

Question 10

What must you avoid when placing an oesophagostomy tube?

Answer 10

Jugular

Question 11

How do you check oesophagostomy tube placement?

Answer 11

Radiograph

Question 12

How do you secure an oesophagostomy tube?

Answer 12

Fingertrap

Question 13

How do you bandage an oesophagostomy tube?

Answer 13

Loosely, not vetrap

Question 14

What is the advantage of a gastrostomy tube?

Answer 14

Long-term feeding at home

Question 15

What is the indication for a gastrostomy tube?

Answer 15

During abdominal surgery, if there is oesophageal disease

Question 16

What are the disadvantages of a gastrostomy tube?

Answer 16

Risk of peritonitis, can’t remove before 7-10 days

Question 17

Which part of the stomach do you place an gastrostomy tube?

Answer 17

Closest to the skin

Question 18

What are the uses of a thoracostomy tube?

Answer 18

Remove fluid or air or deliver anaesthesia

Question 19

What are the three types of thoracostomy tube?

Answer 19

Trochar, non-trochar or Seldinger types

Question 20

WHich type of thoracostomy tube needs a GA?

Answer 20

Trochar

Question 21

How many rib spaces forward do you go in a trochar placement?

Answer 21

2-4

Question 22

What equipment do you need for trochar placement?

Answer 22

Clamps, 3 way tap, cone, vest, observation

Question 23

What are the advantages of Seldinger types?

Answer 23

More comfortable, only need local and light sedation, more secure

Question 24

Which effusions can you use seldinger for?

Answer 24

All

Question 25

When do you remove a chest drain?

Answer 25

When air is negligible and fluid is below 2-4ml/kg/day

Question 26

Where should a drain always exit?

Answer 26

Separately from the wound

Question 27

When do you remove a Penrose drain?

Answer 27

When fluid reduces or after 3-5 days

Question 28

When should you use active suction?

Answer 28

If oncological, infected, to prevent seroma

Question 29

When do you turn on an active suction drain?

Answer 29

6-8 hours after placement once fibrin seal has formed

Question 30

When do you remove an active suction drain?

Answer 30

WHen production below 2-4ml/kg/day

Question 31

What is an advantage of active suction?

Answer 31

Less ascending infection