Difference between Salem Sump & Dobhoff?

[Jess05]

Hi, I'm a nursing student trying to understand NG tube feeding. I'm confused why we use 1 port for feeding, irrigation, suctioning, and meds for Salem Sump. Meanwhile, we use 2 ports for Dobhoff for meds and feedings. Why would we need 2 ports for Dobhoff when we could put them in one port similar to Salem Sump? Can someone explain??

[Wuzzie]

Salem sump tubes are used for gastric decompression and should not be used for anything else except in very rare occasions (contrast dye in the case of patient intolerance comes to mind but that would be highly unusual). Dobhoff tubes cannot be used for decompression and are limited to feeding and meds. The secondary port on the Dobhoff allows for medication administration without disconnecting the tubing or stopping the feed. 

[way2gd24get]

We use Salem sump (NGT,OGT) in the ICU, more than we use nasoduodenal tubes (Dobhoff). When someone is intubated we usually utilize the OGT method. We use it for decompression or tube feedings. We make sure to check residuals every 4 hours, to ensure the patient isn't harboring too much tube feed in the stomach. Rarely do we use dobhoff tubes in our ICU, but we have a new doctor that is ordering them more frequently. These should be placed via the nares. It's important to keep the guide wire in during placement and they must be buried from 75-80 cm for optimal placement in the duodenum. Once you suspect you're in the right place, then you retract the wire from the tube. It  is important to remove the wire once it is placed because it makes the tube pliable, for movement within the stomach. Optimally you need to wait about 2-3 hours to shoot the abdominal x-ray to allow for the stomach to move the weighted tip through the pyloric sphincter. Now, if you're lucky and work in a place that has Cortraks, you can actually see the movement of the Dobhoff on the machine that tracks it. Still need x-ray confirmation though. Leave the guidewire in the room. If the tube becomes dislodged/accidentally retracted. You must remove the tube from the patient before placing the guidewire back in to the tube. You cannot place the guidewire back in the patient while the tube is still inside of them. If you don't want to do this, you can always just grab a new tube. Residuals do not need to be checked while the tube is in the duodenum. Actually, it might be troublesome and will compromise the tube since the lumen is so small and the tube is so pliable; the tube will collapse from the negative pressure exerted on the tube during the aspiration process. Putting medications down Dobhoffs can be tricky. If a liquid solution of the medication is not available, it is important to crush and dissolve the medications entirely, or you will clog the tube. I do not recommend using the side port to administer these medications; unhook your tube feed, flush and then admin meds, then flush again with at least 30 ml of fluid. That is all I really know on these types of tubes.