[kaibigan]

another trivial question, i may say.

if the baby is on continuous suction and is attached to a repogle, is there a need to aspirate for drainage every 3 or 4 hours (during cares)? any opinion?

[sparkyRN]

We generally use an intermittent low suction for gastric drainage; it is supposed to be less irritating to the stomach lining. Our protocol used to require us to irrigate the OGT q4h with saline then aspirate to assure patency. Fortunately, it's been awhile since we've needed to use this. The nurses are less likely to aspirate and irrigate if the system is draining well and will only do it if bile is no longer flowing or the abdomen is becoming more distended. I usually irrigate/aspirate at the beginning of my shift then prn if flow stops.

[fergus51]

Our protocols are the same as Sparky's. I've never seen a replogle attached to continuous suction.

[JenKatt]

Once in a blue moon we'll use continuous with some of our really bad gastrics, but even with intermittent, we'll only aspirate/ check patency once a shift or if we're gotting nothing out and the baby's belly is getting bigger

[BittyBabyGrower]

One of our peds surgs like the repogyles...they are softer than a Salem.

We only irrigate if there is an order, which most of the time there is..we do have the occas. kid that they don't want any suture lines messed with by putting irrigate down there. Most of the time we leave them be if they are draining well and the belly looks okay.

[KRVRN]

If the repogle is giving active output, I don't aspirate since it's obviously well-placed and patent. If it's giving little or no output or abd is distending, I aspirate and auscultate for patency. I rarely lavage, because in my mind, if I'm not getting output and I can't aspirate anything, and auscultating doesn't reassure me that it's well-placed... I'm sure as heck not going to instill fluid, it might not be in the stomach! At that point I'll usually check to see if the baby has had a recent x-ray.

One time I had a little 24 weeker with a repogle to LIS post-op. Not a bit of output, so I aspirated and auscultated for the air woosh. Nothing aspirated and couldn't hear a thing. He had an AM CXR, so I looked at it. There wasn't an OGT even visible on CXR! Hmmmm, there's one taped to his face! Feeling inadequate and sheepish about myself, I asked the doctor to look at the CXR--nope, no OGT. Sure enough, turns out 14cm's worth of 8 fr repogle was coiled in the micro's mouth. And had been for days! Luckily he was fine and a new OGT dropped didn't yield any drainage.