Flashcards in NG tube for decompression Deck (10):
What are the different types of nasogastric tubes?
Usually large bore tubes with wide openings.
More common in ER settings
Gastric tubes( the Focus of this week)
what is a Levin tube?
Single Lumen14-18 Fr for decompressing
Used to withdraw specimens for diagnostic analysis, washing the stomach free of toxic substances, and irrigating the stomach to diagnose and treat upper gastrointestinal bleeding.
The Levin tube is connected to low intermittent suction (30 to 40 mm Hg) to avoid erosion or tearing of the stomach lining
What is a salem sump? aka the blue pigtail
Double lumen,120 cm long,12-18 FR
Attached to Suction
Pigtail-Smaller Air Vent
THE BLUE AIR VENT limits the suction force to 25mm Hg
The smaller second lumen terminates in a blue vent, or “pigtail.” (This inner, smaller tube vents the larger suction-drainage tube to the atmosphere via an opening at the distal end of the tube)
What is the blue pigtail on the salem sump?
The blue vent is always open to the air, providing continuous atmospheric air irrigation
When irrigating the large lumen, inject 20 mL of air into the blue vent to re-establish a buffer of air between the gastric contents and the vent.
Clamp off the air vent
connect it to suction
or use it for irrigation.
What is monitoring and maintenance for a decompression NG tube?
Maintaining a NG
NG for Decompression on suction
Measure and record drainage from the NG
Provide oral and nasal care (tape change, nasal mucosa, ice chips if ordered )
Measurement (It might be unattached or dislodged if patient has severe coughing fit or other choking experience. Check regularly especially before use )
In and outs are important for electrolyte balance.
Irrigation NS or Water (q 6-8H, Dr order or VIHA policy ). If difficult to irrigate , try repositioning the patient, injecting air - Think about repositioning patient)
Record amount, color and type of drainage
How do you irrigate the decompression NG tube?
30 cc of Saline or Water or Air
Clamp NG tube/pinch tube feed
Insert tip of syringe. Slowly and evenly inject saline.
If resistance, Do not force irrigation.
Check for kinks
Move patient to left side.
Aspirate to remove fluid/return gastric content
If more or less fluid document on I/O
Reconnect NG to suction or feed
Mouth care is very important as the mucous membrane can become dry and sore so important to offer regular oral hygiene.
How do you remove the NG tube?
Trial periods before removal
Clamp the tube for several hours or remove from suction
Observe patient (abdominal concerns)
Dr’s Order to remove
Listen for Bowel Sounds
Talk about procedure
Disconnect from suction or drainage.
Position the patient in semi fowler's position
Insert 20 ml of fluid
Deep breath and hold breath, pull out tube evenly and quickly.
Continue to assess patient. http://www.atitesting.com/ati_next_gen/skillsmodules/content/nasogastric-intubation/viewing/remove-naso-tube.html?id=undefined
What are some differences between NG feed and NG decompression
Does NOT need xray
does not use a guide wire
cannot be used for feeding
One of the popular tubes (
What are some tips mentioned in class?
Salem: air vent, never clamp, irrigate or suction the air vent
-air vent doesn’t allow suction
-if air vent fails, it is like the levin tube
Blue part- air vent
Blue to blue- valve
Curve tip to help with placement
-use the heat of your hand
Rotate 180 when you feel it hit the back of the throat
Pigtail above the stomach
Decompression doesn’t need xray
Water soluble solution if breakdown in nose- no vaseline
Mucosal breakdown in stomach- brown content
Squeaking/whistling- irrigate the tube to try and get rid of the sound
Throat irritation- ice chips