Having trouble understanding the different types of NG tubes

[tsm007]

I am reading and reading on NG tubes trying to make sure I understand how they work and what they are used for. I find that if I don't truly understand the why of things I won't be able to learn the steps for the skills. What is the difference between large bore and small bore? I kind of get the differences, but can't really understand why you would choose one over the other. We have mostly worked with salem sump tubes. What I can't understand is if you can feed with this tube and suction, why you would want to use other tubes for feeding? Salem sump is a large bore tube correct? I guess I'm not really getting the purpose of small bore tubes. If NG tubes for feedings are for short term (which I'm assuming they would be or they would insert a G tube or something more permanent) then why would you choose another type besides the salem sump? Wouldn't you want to use a feeding tube that you could suction with too if you ran into problems? I don't know. I am still so new at all of this that I feel like I am not getting it. I am also having trouble knowing how to identify the different parts of the NG tubes and caps that come with them and where they should go. Any tips for that would be helpful too.

[Esme12, ASN, BSN, RN]

We are happy to help.......show us you are trying to figure it out and we'll shine the light! ((HUGS))

[nurseprnRN, BSN, RN]

What we do for fun :)

Glad to help. We remember (oh, god, so clearly...) what it was like to be young, inexperienced, and clueless. Later on when you have more experience and understanding, remember how it felt and you'll be able to explain better too.

[classicdame, MSN, EdD]

One thing to add-please be sure you know if meds can be placed into the tube. Many cannot, so you will need to alert MD if another route or another medication is required. Also, some meds are absorbed in the stomach, so they need to be administered via tubes that terminate in the stomach. A Dobb-Hoff (weighted tube) terminates in the duodenum, past the stomach. A majority of digitalis is aborbed in the stomach, so if the patient has a Dobb-Hoff they will not receive therapeutic levels of dig.

So glad you are questioning this now!!

[nurseprnRN, BSN, RN]

Right-- so any tube that goes into the GI tract below the stomach-- Dobhoff, J-tube, etc.-- you need to remember this and be sure your physician orders are appropriate. Believe it or not, a lot of them don't remember that part when they say to continue oral meds via tube.

[Benj2610]

Thank you all... so many little details are left out in formal education! So I have another question about an NG tube... the thinner tube (used for feeding & meds with the ko pump which I believe they called a "cortrak" at my last job - brand name). I had a patient with the NG tube who was NPO, it was only used for administering PO meds & was never connected to the pump. Does it matter which port I use to administer the meds knowing that it was never used for feeding/never hooked up to pump (no formula had ever been out into the lumen)

I ask because gravity alone didn't do a whole lot, my preceptor showed me using a bulb syringe going through the main port typically for feeding. And I was wondering if there would be less resistance using the port designated for PO meds. In my last job, my experience was always with someone that had continuous feeding and I seem to recall the meds going down easier.

[NicuGal, MSN, RN]

Never put anything down the pigtail except air, that is "vent" if it does need to go to suction.

[Benj2610]

Not talking about sump... The thin yellow tube for feeding & PO Meds used with the KO pump has two ports at the end.

[NicuGal, MSN, RN]

Best practice so it becomes habit would be use the port designated for meds ?

[Benj2610]

Thank you... that makes sense to me.

[FineAgain]

Just to add...at my hospital (and I suspect others) only the ICU is allowed to give meds or tube feeds through an NGT unless specifically ordered by an MD, and this is usually on a one time order (like Tylenol). Small bore feeding tubes are inserted with ultrasound (Cor-Trak in our case) and used for feeds; we use these for patients who don't need a JT or GT long term but need tube feeds on a short term basis.

[icuRNmaggie, BSN, RN]

I would just like to add that this is why it infuriates me when pts come from the ER with the blue port tied in a knot.

[classicdame, MSN, EdD]

I also recommend, if you know the name brand, to google their website. You will find education there for specific items.