Intermitant or continuous suction for salem sump NGT?

[stalsrn]

I was taught during my orientation to surgical floor to always put NGT, especially salem sump, to continuous low suction. Some of the other nurses are now telling me that continuous is not right, should be intermitant only. The policy for the floor states continuous which is what I always do. Yesterday a day shift nurse told me I was wrong and the policy was wrong! She said a MD told her to never use continuous and always low intermitant. What do you all think? What is the correct answer? Thanks in advance!

[dollphyn]

stalsrn said:

I was taught during my orientation to surgical floor to always put NGT, especially salem sump, to continuous low suction. Some of the other nurses are now telling me that continuous is not right, should be intermitant only. The policy for the floor states continuous which is what I always do. Yesterday a day shift nurse told me I was wrong and the policy was wrong! She said a MD told her to never use continuous and always low intermitant. What do you all think? What is the correct answer? Thanks in advance!

The doctors I work with when putting an NGT in, tell me low intermittent wall suction. Our NGT's are only the salem sump at the hospital I am at. I actually do not know what our policy is at our hospital, I have just been going by what the doctor order tells me to do.

The only time I use continuous is if I have an oral patient or pt's that have JP drains after mastectomies. Hope this helps.

[nlion87]

Always low intermittent suction

[Jolie, BSN]

I respectfully disagree that intermittant suction is necessary with a Salem Sump tube. A Salem Sump has 2 lumens, one for drainage and one for air flow. Continuous suction is appropriate and safe with a Salem Sump because the air lumen prevents suction from being applied to the stomach wall, causing mucosal damage.

A Levin tube is a single-lumen tube, which requires intermittant suction to prevent suction from being applied to the stomach wall (in the absence of secretions) causing mucosal damage.

http://findarticles.com/p/articles/mi_qa3689/is_200303/ai_n9200803

The Salem sump and the Levin tube are commonly used NG tubes that are placed for GI decompression or drainage. The Salem sump has two lumens, one for drainage and one for air. The drainage lumen is usually connected to low continuous suction. At times, however, higher levels may be needed. The air vent keeps the tube away from the stomach wall to prevent damage to the mucosa. The single-lumen Levin tube is typically connected to intermittent low suction for the same purpose.

[fins]

The reason that single lumen NG tubes aren't put to continuous suction is so that the vacuum doesn't pull it against the stomach wall, damaging tissue. The second lumen of the salem sump allows air to be pulled into the stomach, preventing that vacuum from forming, so the tube doesn't migrate to the stomach wall. So there's no reason not to use continuous suction with a salem sump. That being said, there's no harm in using intermittent suction, so you'd have to decide how important a battle this is to fight.

[stalsrn]

You are all wonderful! Thank so much for the answers. We only have salem sump NGT at our hospital so I guess the policy is right, although I will go with the MD's order regarding suction. Thanks again!

[adnrnstudent, ASN, RN]

2nd year nursing student here working as PCT. I found this thread doing research on this issue because we use continuous at work and the nurse like to set it to the high side of low. I like definitive numbers so I started researching it.

Using a salem tube:

If continuous is used, setting should be 30-40 mmHg. For more than that go to intermittent up to 120 mmHg.

Low Continuous covers a lot of numbers, so I wanted to know more specific so I started looking around.

[MunoRN, RN]

Salem Sump's can be run on continuous when the vent lumen is patent, and in a perfect world that blue lumen is always open, but that's not always the case. It can get fluid in it and not allow free air flow, and if the filter cap (the one that the Docs throw away when they round) gets moist then air stops flowing through it.

I usually run it on continuos until the stomach contents have emptied after first placing the tube, then switch to intermittent if that's enough to keep the stomach empty and decompressed. This does the same job but helps protect the stomach mucosa should the blue lumen clog in between checks of the vent tube.