NG tube question

[parrot07]

Hello. So I have been a nurse for 1 1/2 years. I have had some pt's with NG tubes. Recentely however I had one that was a salem sump NG tube. It was set up to suction and orders were to flush with 30 ml q 4 hours. Is this the correct nursing procedure steps?

Disconnect NG from suction canister,,,,(does the contents from the canister end of the tubing leak out or are we supposed to clamp it somehow?)

Insert 30cc of air into ng tube and listen for placement

Insert 30cc of nss or water

Insert air again????

Hook back up to suction.

Big question- what is the blue tube for?? I know it has to do with air pressure and preventing suction to stomach wall,,, but do we ever mess with that?? Is it supposed to be open or do we clamp it???

Any guidance would be great. First time with the salem sump. Of course I went home and read up all about it, but I would like to hear

RN

's view on the process and any little secrets that help out.

thanks!

[neutrophil]

Well, I am a little concerned. The blue port. It is Taboo. As in a student nurse is beat up over his or her head about it. It is a vent and every nurse knows or should know that. As far as placement. It does not matter if it is an NG or PEG. You still need to check placement and residual. I don't care if someone says. "It is continual, so don't have to check for placement." Check it. Other things, well you will have to figure them out, but the essentials are essential. Good luck.

[iluvivt, BSN, RN]

You got it...the sump tubing allows air in to keep the tube away from the stomach mucosa..I see some nurses clamp this for their convenience so the bed does not get messy....this takes away the function of the sump and is not advised. There is a little valve that you can add to it that still lets it do its job as a vent and air source and prevents it from leaking all over the bed

[Penelope_Pitstop, BSN, RN]

Well, I am a little concerned. The blue port. It is Taboo. As in a student nurse is beat up over his or her head about it. It is a vent and every nurse knows or should know that.

In late 2007, our (at the time) chief Surgical resident told me I could and should use that port. I balked, and told him pretty much what you've posted here. He sort of rubbed his chin, explained to me a lot more about the Salem sump than I could ever care to know, then said we both should look into it...if a nurse could do it as well as a doctor.

I don't think either of us ever looked into it, as it's 2010 and we're both at different hospitals...

[GM2RN]

I turn the suction on to "continuous" just prior to disconnecting the tubing. That way the contents in the tubing to the cannister is sucked into it and does not leak out. Just make sure you turn it back to intermittent. Best to do it right away so you don't forget.

As for the NG tube leaking, I make sure to hold it high enough to keep it from leaking until I insert my air bolus.

[parrot07]

Thanks so much for your reply. Yes I did turn it to continous first but the contents were kinda thick so it wasn't sucking it up there.....

[GM2RN]

Thanks so much for your reply. Yes I did turn it to continous first but the contents were kinda thick so it wasn't sucking it up there.....

In that case, place a towel down before disconnecting and let the contents drain.

[XingtheBBB, BSN, RN]

Look into the fabulous device called a "lopez valve" It's a stopcock that fits between the gastric tube (any type) and the suction line or feeding set. Gives you access to the tube with less mess (even for me! but I still lay down a towel first) Without if, if you expect a lot of mess, or are worried about meds venting out and spilling, I put a kelly on it. Often I keep an air bubble (10 ml-ish) in my toomey and push that in as an "air lock" after my meds and flushes to give me an extra second to reconnect. (obviously, back to suction if just flushing, clamp if meds are given)

Leave the filter plug on the blue line for less mess. It's the plug that initially loops the clear and blue ports together. keep it blue to blue.

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

Excellant adice one and all. Many years out of school and gives me a good refresher.

As for doctors and NG tubes, don't, just don't. I was tied up in a code so an excellant but impatient surgical resident put an NG in my patient, then instilled 50 grams of activated charcoal, in the patients right lower lobe lung! To this day it bohers me that the patients' advocate couldn't be there to protect the patient from the doctor.

[scruffygurl]

As a Nursing Instructor I can say with full confidence the blue port is a NO-NO. We stress that the blue port is the air vent for the suction. Do not plug or clamp. I can also say, given a family members' current hospitalization, newer nurses do not know what to do with an ng tube. Mess everywhere, all over his hands, the floor, and every where. Nurse was so upset, patients wife had to clean up the mess with a used brief! Student ask questions! Read your text! Watch your ATI or Shadow Health, which ever virtual study edition used in your program.