Irrigating NICU gavage tubes

[aecbegno]

I am curious about irrigating indwelling gavage tubes.... what do you irrigate with, how often, do you count the amount in I&O, any good references in the internet or journals as to pros and cons of routine/after feeding irrigation?

Thanks for your input!

[Gompers, BSN, RN]

We don't irrigate regular NG tubes, but I think it might be a good idea to push 1cc of sterile water in after each feeding, to clear the tube of any breastmilk or formula. I usually push 1cc of air through the tubing, to clear it as best I can.

We do irrigate Salem Sump or Repogle tubes because they tend to get clogged if the baby has thick secretions and is on suction. If the tube is draining good amounts of thin secretions, there is no need to irrigate so we don't. If we're not getting much or if it's really thick, we irrigate about once per shift. We use sterile saline flushes, and only push in 1cc to clear the tubing, then either pull back on the syringe or set back to suction. We don't count this as intake, since it's not in the baby's stomach for longer than a few seconds. All we do is subract 1cc from whatever is in the collection cup when we measure it post-irrigation.

[dawngloves, BSN, RN]

Never irrigated a tube. I will pull back on a Repogle if I'm getting no drainage or instill a cc of air and pull back.

[BittyBabyGrower, MSN, RN]

We don't either. Same as gompers. If it is a big chronic kid that gets tons of sticky meds or has thickener, we will flush the feeding tubes with 1-2 mls sterile water and count this as intake.