NG tube irrigation

memphispanda, RN · Aug 30, 2003

I hope you get an answer to this, because I have been wondering about this same thing! I have seen NS used, sterile water, and plain ole tap water. I don't know why tap water wouldn't be used unless there was some major risk of infection or something wrong with the water, because the GI tract isn't sterile. Maybe I am not thinking about it the right way...I don't know.

renerian, BSN, RN · Aug 30, 2003

We used tap h20 as well.

renerian

Going80INA55 · Aug 30, 2003

One of the reasons sterile water or tap water is used verses NS is the salt content. The new nurse is correct it can through off the lytes in a patient.

RNMBA · Aug 30, 2003

This sounds like a good question for some MSN student to take on as a project.

I can't imagine the small amount of fluid normally used for irrigation to be of any great concern. The lack of research on this topic means that individual practice is based on opinion instead of evidence.

gwenith, BSN, RN · Aug 30, 2003

20 mls of saline will NOT electrolytes imbalance:D

Sterile vs tap water - here is the REAL reason.

If we are talking about an NG in a patient who has normal gastric PH then tap water is fine. If for some reason the PH of the gastric contents has been altered then one of the major defenses against pathological bacterial invasion has been lost and sterile water should be used. This goes for NJ tubes as well.

Now unblocking tubes - we always used coca cola but a colleague recently informed me that the tubing can be affected by coke ( boy don't you just love that stuff:D) and we should be using sodium bicarbonate instead.

So since we are on the subject of NG's can anyone shed more light on this one as well

SharonH, RN · Aug 30, 2003

This is interesting. I hav always used plain tap H20 and gwenith's explanation aside, I think it could be used for the majority of cases. I certainly wouldn't use NS, what a waste. This goes to show how much of nursing practice is based on anecdotal information and old habits versus actual research.

As far as unclogging the tubes, I heard that some studies have indicated that warm H20 is as effective as Coke, apple juice, meat tenderizer or any of the other remedies.

moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS · Aug 31, 2003

Same here. I have always heard of using tap water. Never heard about using sterile water or normal saline. Learn somethin' new everyday.

gwenith, BSN, RN · Aug 31, 2003

I came across this explanation in one of my researchs into prevention of "ICU poo". I will try ANYTHING to reduce the amount of diahorrea I have to contend with in ICU. The removal of the bacterial barrier afforded by a high gastric ph was one of the concerns in relation to the use of H2 receptor antagonists.

Certainly if you have a patient on ranitidine or one of it's relatives and you have diahorrea of unknown origin I would consider swapping to sterile everything for a while to see if that helps.

Agnus · Aug 31, 2003

I went to school in the past 5 years. Tap water is used. Additionally every facility that I am familar with uses tap water.

The stomach is never a steril enviorment. Yea an acid imbalance could cause problems. Think about this. If you do not have an NG and you drink your fluids and you have a lack of HCL you still do not drink a steril solution nor do you drink N/S.

An NG tube only by passes the fluid comming in contact with the tissues of the mouth and throat. It does not alter anything about the stomach. NGs are used most often when there is a swallow problem and not because there is a stomach problem.

Most of the time I am sucessful unclogging tubes with warm H2O. Bicarb is useful if prevacid is blocking the tube. It is the Acid in coke an fruit juice that supposedly unblocks the tube. But like I said warm H2o has been my best friend here.

Some one said that 1-2 oz of NS wont upset lyte balance that bieng said, 1-2 oz of tap water in the stomach where tap water is normally put will do no harm. So why use $$$ N/s or steril water?

As far as diarrhea goes we do not treat diarrhea with 1-2 oz N/s nor steril H2o so why would you just because there is an NG. We don't even when they are on a proton pump inhibitor

Buddha · Aug 31, 2003

Tap water here.

meownsmile, BSN, RN · Aug 31, 2003

I have to admit i didnt really consider the sterile water and diarreha issue. But i will remember it now,, thanks. We use regular tap water usually, but if the patient is having tube feedings we use diet 7-up. The carbonation cuts the build up in the lumen of the tube well, and if you are checking residuals there is no added color to the stomach contents like there might be with the Coke. Using diet also doesnt add to the dietary calculations if on feedings(sugar or calories).