History of Varices an Absolute Contraindication to an NG?

Published

Specializes in being a Credible Source.

I'm wondering...

Do you or your department considering a history of varices to be a strict and absolute contraindication to placement of an NG tube?

We were faced with this situation and placed the tube because there was no practical alternative and the attending (a very smart and competent doc) said that there is no consensus in the research data to declare 'stable' varices an absolute contraindication in a person for whom the tube is necessary for vital treatment.

Up Vote Up Vote ×
Specializes in Medsurg/ICU, Mental Health, Home Health.

In that case, I prob would have asked the doc himself to place it, or at the very least consult surgery for its placement. The surgical residents at my facility would have placed it or had it placed in interventional radiology.

I believe it is considered an absolute contraindication to NURSING placing the tube. At least where I work. (Level I teaching trauma center).

Up Vote Up Vote ×

I doubt very much that the procedure for a doc to sink a Salem sump is one bit different from the way I would do it...but with someone with varices, at least when they tear the doc is still there to deal with it! ("all bleeding stops eventually...." love it)

Up Vote Up Vote ×
Specializes in Emergency.
I doubt very much that the procedure for a doc to sink a Salem sump is one bit different from the way I would do it...but with someone with varices at least when they tear the doc is still there to deal with it! ("all bleeding stops eventually...." love it)[/quote']

Agree, I think that the only reason to have the doc do it if it is absolutely necessary to be done is to have him/her Johnny-on-the-spot and maybe dodge liability. I certainly wouldn't want a resident doing it considering the only time I see residents dropping an NG is while I'm teaching them to do it. It's kind of like saying "maybe we should ask the doctor" about a difficult foley/IV insertion. Unless it is a urologist or an anesthetist you won't be getting any expertise there.

Up Vote Up Vote ×
Specializes in Medsurg/ICU, Mental Health, Home Health.
Agree, I think that the only reason to have the doc do it if it is absolutely necessary to be done is to have him/her Johnny-on-the-spot and maybe dodge liability. I certainly wouldn't want a resident doing it considering the only time I see residents dropping an NG is while I'm teaching them to do it. It's kind of like saying "maybe we should ask the doctor" about a difficult foley/IV insertion. Unless it is a urologist or an anesthetist you won't be getting any expertise there.

Our surgical residents are awesome with NG tube insertions. But I prefer to drop them myself. I just ain't got time for causing no hemorrhage!

Up Vote Up Vote ×
Specializes in Emergency.

Our surgical residents are awesome with NG tube insertions. But I prefer to drop them myself. I just ain't got time for causing no hemorrhage!

Agreed, we still use the good old linton tube, but I'm not touching that bad boy with a 10 foot pole.

Good that your residents do typical "nursing procedures" I always thought it would be useful.

Up Vote Up Vote ×
+ Join the Discussion