Gastric content aspiration- No residual and with resistance HELLLP!!

  1. 0
    Hello!
    I need help with G-tube feeding please!! PLEASE PLEASE

    My company has its own policy, but just to be safe, I follow the policy as well as
    what I learned from the books. I just can't exactly remember it, though. Please help mee!!!
    I don't want my supervisor to know that I am not confident with what I am doing..

    For bolus feeding, this is what I do in order:
    1.flush with water as per doc's order
    2.administer feeding as per doc's order
    3.flush again with water

    My problem is with checking for the placement of the G-tube. Before I
    do the steps aforementioned, (please teach me please teach me...)
    -I place my stet at the lower epigastric area and inject 10cc of air, and listen for THAT sound.
    -I aspirate gastric contents by injecting 30cc of air and then aspirating for the gastric content.
    If it's milky in color- that's the residual from the previous feeding. If it's more than 100, wait 1 hour before giving the feeding (after checking for gastric contents again)
    If it's the gastric juice, inject it back and start the feeding by doing step 1.
    My question is, how come sometimes when I try to aspirate for gastric content, nothing comes out? Am I doing it right? While aspirating, I lower down the tube to let the gastric content flow down by gravity.
    Helllp what do I do?? I'm afraid the tube might not be in place and I am administering the feeding!!!

    Also, If there is a little blood in the tube (might be due to irritation), do I aspirate it or do I flush it?
    Thanks! I would really appreciate some help here...

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  2. 3 Comments...

  3. 0
    I guess I haven't ever injected more air right before aspiration.
    I usually inject 20-30cc air when checking for placement, with stethoscope over stomach listening for the "whoosh". Then immediately pull back for residual. (Don't usually get anything or much for residual) The resistance is because there is nothing there to pull out. (Just like when removing a foley... you attach the syringe all the saline comes out of the balloon into the syringe... when you pull back on the syringe there is resistance meaning all the saline is out of the balloon.) So, I think no residual is normal, and you just have to make sure you hear the whoosh when checking for the placement. Adding a little more air (the 20-30cc vs. 10cc when checking placement will make it easier to hear it too.) I'm a student, but just took care of a patient with a g-tube and this is how I did it with my instructor.
  4. 0
    Why would you inject another 20 to 30 cc of air after the first 10 cc?

    After injecting the 10 cc of air, pull back and see if you get residual.

    If you meet resistance it could be because the g-tube wasn't flushed and got clogged. You could try pushing warm water through it.

    A trick I was taught is to use about 50 cc of cola to clear the clog then flush with another 50 cc of water. It works
  5. 0
    first off i googled to find the what the color of gastric content would be thinking it would be quicker and i realize this post is old...but we are learning this now and if you don't get any residual at all then your tube is placed incorrectly that's the whole point in aspirating...you should ALWAYS get gastric content because it's always there! so if you're getting nothing your tube is in the wrong place!



    Quote from babinski123
    Hello!
    I need help with G-tube feeding please!! PLEASE PLEASE

    My company has its own policy, but just to be safe, I follow the policy as well as
    what I learned from the books. I just can't exactly remember it, though. Please help mee!!!
    I don't want my supervisor to know that I am not confident with what I am doing..

    For bolus feeding, this is what I do in order:
    1.flush with water as per doc's order
    2.administer feeding as per doc's order
    3.flush again with water

    My problem is with checking for the placement of the G-tube. Before I
    do the steps aforementioned, (please teach me please teach me...)
    -I place my stet at the lower epigastric area and inject 10cc of air, and listen for THAT sound.
    -I aspirate gastric contents by injecting 30cc of air and then aspirating for the gastric content.
    If it's milky in color- that's the residual from the previous feeding. If it's more than 100, wait 1 hour before giving the feeding (after checking for gastric contents again)
    If it's the gastric juice, inject it back and start the feeding by doing step 1.
    My question is, how come sometimes when I try to aspirate for gastric content, nothing comes out? Am I doing it right? While aspirating, I lower down the tube to let the gastric content flow down by gravity.
    Helllp what do I do?? I'm afraid the tube might not be in place and I am administering the feeding!!!

    Also, If there is a little blood in the tube (might be due to irritation), do I aspirate it or do I flush it?
    Thanks! I would really appreciate some help here...


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