OG Tubes after Intubation - suction

[Genavina]

After an OG tube is inserted in an intubated patient, when and how do you connect to suction? After radiology confirmation? Low intermittent? Do you do this for all intubated patients?

[Nalon1 RN/EMT-P, BSN, RN]

NG/OG tube placement verification will vary by facility.

Where I am, all intubated patients need a gastric tube hooked up to intermittent suction unless contraindicated (bariatric surgery pts primarily) or direct physician order. We are allowed to hook up suction after insertion with auscultation/aspiration verification, but they do want radiological confirmation at some point.

And just a pet peeve, I hate OG tubes. They are harder to secure (they should not be secured to the ET tube or any ET tube securement devices) and when a patient is extubated, you have to remove the OG tube, and if they are on tube feed or still need the gastric tube, you now need to put a NG in (while they are now awake vs when intubated they were more than likely unconscious or at least heavily sedated).

[RookieRoo]

We hook up right away, but no feedings until confirmed placement via radiology.

[MYSTICOOKIEBEAR]

Have the suction tubing ready to go, once you auscultate and verify it's position is gastric in nature, connect the suction tubing to the OG/NG to LIWS (Low Intermittent Wall Suction). If you are going to give any medication or administer any feeds MAKE SURE to have radiographic confirmation with an abdominal xray that is read by a radiologist, cleared by your MD, and that the order "Okay to use" is in. Always make sure to CYA and do things by the book.

I automatically insert an OG/NG for all of my recently intubated patients just to prevent aspiration and to administer meds UNLESS the patient had an esophagectomy, lung transplant, other upper GI surgery, or unless otherwise contraindicated (already has a DHT with loose BMs, has an G tube or J tube with regular BMs etc).

Since we are talking about intubated patients, I recently made a video about ICU Nurse's role in endotracheal intubation in the critical care setting that might help you out as well. Hope this helps, cheers!

[sissiesmama, ASN, RN]

NG/OG tube placement verification will vary by facility.

Where I am, all intubated patients need a gastric tube hooked up to intermittent suction unless contraindicated (bariatric surgery pts primarily) or direct physician order. We are allowed to hook up suction after insertion with auscultation/aspiration verification, but they do want radiological confirmation at some point.

And just a pet peeve, I hate OG tubes. They are harder to secure (they should not be secured to the ET tube or any ET tube securement devices) and when a patient is extubated, you have to remove the OG tube, and if they are on tube feed or still need the gastric tube, you now need to put a NG in (while they are now awake vs when intubated they were more than likely unconscious or at least heavily sedated).

I hate OGs too!!

Anne, RNC

[Magsulfate, BSN, RN]

I concur also. Unless the Nasal passages are obstructed, go for the nares.

[canoehead, BSN, RN]

I'm in the ER, and always assumed there was a reason the ICU wanted an OG for vented patients. An NG is fine too? It would be easier to secure for me, and away from all the oral secretions.

[Wile E Coyote, ASN, RN]

The preference of OG over NG tubes is due to the higher risk for sinusitis associated with NGT's (class IV recommendation...limited clinical studies showed correlation per the last time I looked it up in the AACN procedure manual)

[Lev, MSN, RN, NP]

We automatically hook up to LIS suction before the xray and after auscultation. We go for OG but will try for NG if unable to get an OG. NGTs are harder to get in when your patient is not sitting up straight or able to tuck their chin.

[Maevish, ASN, RN]

I've also usually done the CLWS or ILWS (and a lot of the time the doctor will order it), but it depends. 8 times out of 10, though, they get the suction right away. Some hospitals let you confirm placement by auscultation, but some make you do an XRAY or check the pH of the suctioned matter before feedings are started.

xo

[jj224]

We used to put in OGT immediately following intubation. That way, when x-ray comes to do the CXR we can have them do a KUB quickly that the fellow could see right away - makes it easier if we need to do feeds later. If not with intubation, I'd just hook it straight up to suction and make sure it's known there hasn't been x-ray confirmation of placement in case someone wants to use it for feeds.

[CVICURNMC]

Where do you secure the OG tube if not to the ET tube?