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Discussion

NG Tube

So I'm a new nurse who has been working for about 3 months now, off orientation for about 2 weeks. I'm still very overwhelmed but taking it a day at a time. Today I had a patient with a SBO. The patient has a NG tube placed with orders of continuos low wall suction. At the end of my shift I noticed that the amount of gastric content was the same since the beginning of the shift. Long story short, the suction was on intermittent suctioning..not low continuos. I eventually changed it to the correct settings. Was the a BIG mistake that I should've file a report on? I just feel so stupid!

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    I wouldn't worry about it.

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    I agree with loriangel14. However, this demonstrates the importance of verifying that what your patient is receiving is actually what is ordered.

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    At my facility all patients with NG's for gastric evacuation are on low intermittent suction, even if the doctor ordered low continuous suction.

    There is a big risk to continuous suction, even with using a salem sump tube, and no real benefits. On a "low" suction level, the NG will pull about 6 to 8 liters per minute of fluid, depending on the lumen bore. On "intermittent", it's only on half the time, so the volume it can pull is only 3-4 liters per minute. So if your patient is requiring that more than 180 liters per hour to be evacuated then intermittent wouldn't be sufficient, although I doubt any such patient has ever existed.

    While Sump tubes help reduce the chance a tube will become attached to stomach lining by suction, these sump lumens can become clogged extremely easily, in which case you've just got a regular NG and the risks of having a regular NG on continuous suction are well documented.

    So to answer your question, it would have made no difference that the patient's was set on intermittent suction, and you may want to consider critically evaluating orders for continuous suction.

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    hi there. its a pretty common mistake to place a patient on LIWS (low int wall suction) when a physician orders LCWS. its one of those things that you just wanna keep you eye on when you do your hourly rounds. sometimes the ngt might get clamped for a while if the patient wants to ambulate to the restroom and it gets put on with the wrong setting. from my 3+ years of nursing experience, i wouldnt feel too bad about it. at least the patient wasnt disconnected from it for an extended period of time.

    also, if you find that the ngt output has been unexpectedly low, sometimes the tube has been pulled out several inches and its not even in the right place. this has happened multiple times in my experience, especially when you have a patient that is disoriented and attempts to pull at the tube.

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