Can your RNs insert Dobhoff tubes?

Mulan · May 5, 2005

Don't know what state you are in. Have been inserting them for years ever since started working med-surg eleven years ago. No credentialing needed. Inserted like an NG tube, needs xray confirmation for placement after insertion.

RoxanRN · May 5, 2005

It has always been tabu for nurses to insert these tubes in the acute care setting. I recently was reviewing the Nurse Practice Act, which permit this. How have other places instituted and credentialed their nurses? Very curious.

We learned how to put them in in nursing school. I can't count how many I've placed since then. No other special certification/training/credentialing needed.

pricklypear · May 5, 2005

Same here. Never heard of being "credentialed" (sp?) to insert dobhoffs. Maybe some institutions have a problem with them because a stylet is used?

suzanne4, RN · May 6, 2005

I have been inserting Dobhoffs for years and never needed any special certification............it has never been "not permitted" where I have worked...

Which state are you in?

Tweety, BSN, RN · May 6, 2005

Same here, been putting them in the entire time I've been a nurse here. 14 years.

joyful nurse · May 6, 2005

Some institutions require "credentialling" because they are considered higher risk due to the sylet and the fact that and X-ray is the only way to ensure that they are not in the lung in an unconscious pt. Also some say that there are some tricks to getting them to advance into the duodenum.

RoxanRN · May 6, 2005

some institutions require "credentialling" because they are considered higher risk due to the sylet and the fact that and x-ray is the only way to ensure that they are not in the lung in an unconscious pt. also some say that there are some tricks to getting them to advance into the duodenum.

there are some 'tricks' :) we have a standing protocol for reglan 10mg iv q6hr until in place. we also place the patient on their right side if possible. after getting the tube more than half way in, i've had good luck with twisting it clockwise as i advance it (along with the patient swallowing - if able). the theory is the twisting will help the end work its way toward the pyloric sphincter as you advance it. we also attempt to advance them until only about 4 to 6 inches are left outside the nare. then you are nearly guaranteed (99% of the time) it will be in the duodenum when the xray is taken and adjustments won't have to be made, thus can start tf sooner.

Teach1995 · May 7, 2005

Thanks for all of your responses. I have from PA and insertion of Dobhoff tubes are listed in the nurse practice act. It just has never been a practice that has been expected from our nurses. Usually the residents are charged with this task. It is good to know how other places handle this. Thanks again!