Nasal Trumpet Replacing Rectal Tube?

BBFRN, BSN, PhD · Sep 4, 2003

I hope the skinny end goes in the rectum :eek: . Which way do you point the curve so you don't hurt someone? Can somebody explain the steps of placing this thing? Sounds very interesting!

New CCU RN · Sep 4, 2003

The wider part is inserted.... I will get the exact study's title and author when I am at work on Friday and post it.

However, it is less damaging to the rectal area than the balloon, and actually stays in place unlike the rectal tube.... it obviously can only be used with loose stool (which we address with docs and change feedings/etc in order to decrease this), however, it also is better for the skin (because it is not on there irritating it.

The skinny end is what connects to the bag...... it fits to the drainage bag perfectly. We couldn't just start doing this though.......we heard through the grapevine it had been done, brought it to the attention of our manager and did some research... the research supported it and then management agreed to it....... it is now common practice in all of our ICU's

I wish I had the exact journal article . but like I said, on Friday I will get it and post Sat morning (I am working a P on Friday)

Home Health Columnist / Guide · Sep 4, 2003

"The Rectal Trumpet": A soft nasopharyngeal airway has literature support (The rectal trumpet: use of a nasopharyngeal airway to contain fecal incontinence in critically ill patients. J Wound Ostomy Continence Nurs. 2002 Jul;29(4):193-201. PubMedID: 12114937 )

as an alternative to diapers, fecal incontinence pouches, or large rectally inserted foley catheters for patients with ongoing diarrhea that threatens skin integrity or compromises care of critical patients. Users report ease of insertion, effective drainage, and easy tolerance.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12114937&dopt=Abstract

Nrs. LaLa-Land · Sep 4, 2003

Just learned about a nasal trumpet today in school. what is a BSD? Please tell me more!

Home Health Columnist / Guide · Sep 4, 2003

BSD = bedside drainage bag

Zee_RN, BSN, RN · Sep 4, 2003

We rarely rarely use rectal tubes. We frequently use fecal incontinence bags that work great. Our unit has many specialists in fecal bag applications! It's an art.

There are those bottoms, however, that are just not conducive to fecal bag application. I will definitely check out the nasal trumpet article. It just sound way too bizarre -- hence, it's gotta work! Since it is invasive, do you guys get an order for uh, "nasal trumpet PR"?

BadBird, BSN, RN · Sep 4, 2003

We use them all the time, they are wonderful, no leakage, more comfortable for the patients too.

New CCU RN · Sep 4, 2003

Thanks for the link NRSKaren ... that is the same article that is posted on my unit...

We did use the rectal bags, prior to the trumpet discovery...lol, but they still keep the stool on the same part of the skin all the time....

As far as getting an order for them, we don't have to ... we obviously let the docs know it is being utilized but it is just a standing kind of thing... (don't know if it is bc of it being an ICU or why no order is necessary)

We don't use them if it is contraindicated for things like DIC, thrombocytopenia, etc. But again, this comes from standing protocols......

P_RN, ADN, RN · Sep 4, 2003

Well, I'll be darned!!!!!!

Gldngrl · Sep 5, 2003

Thanks everyone! I must say I learn something everyday being here.

So after inserting the nasal trumpet, you can instruct the pt to "blow his own horn"?

:) (I know, that's bad)

jadednurse · Sep 5, 2003

Originally posted by mmb-rnjd
So after inserting the nasal trumpet, you can instruct the pt to "blow his own horn"?
:) (I know, that's bad)

:roll

grneyes676 · Sep 5, 2003

LOL....mmb-rnjd

We use the fecal incont. bags (butt bags, as we call them). I have never seen a problem with stool staying on the skin, we hook them up to LCWS if there is a lot of stool, so it never stays in the bag!!