Gastric residuals- refeed vs. chuck and RATIONALES?

[NICU_Nurse, BSN, RN]

Hi, guys!

I was wondering what your policies were on tolerance of gastric residuals, and whether or not nurses generally stick to the policy (does that seem like a ridiculous question? I can't decide!), or if there is another "anecdotal" type of "rule" that you might go by (i.e., certain docs prefer it certain ways, that was the way you were taught, etc.). I'm particularly interested in *why* your unit/you do this one way versus the other.

As usual, THANK YOU!!! :)

Just FYI, this is a sampling I've gotten so far:

-Tolerate = 30%

-Tolerate = 10%

-Tolerate anything that's not bilious, bloody, or mucousy, or is less than half the feed

-Tolerate 3-4cc worth of residual no matter what the volume is per feed (i.e., could be 6cc, could be 60cc)

and:

-Discard always (if hasn't digested, likely won't)

-Discard as little as possible (save gastric enzymes, and w/MBM)

-Refeed and disregard, continue with feeds

-Refeed and subtract from feed volume

etc., etc., etc.

So there.

[BittyBabyGrower, MSN, RN]

I think there was a thread on this a while ago....ours is the attendings preference. Some feed through everything if the kid is otherwise asymptomatic, some will say anything over 50% pitch and start again, if they are cont feeds, 2 hours worth.

[NICU_Nurse, BSN, RN]

I'll look for the thread right now. I visit sporadically these days, and miss the daily updating. Thanks!

[RainDreamer, BSN, RN]

We don't check residuals unless the baby's abdominal girth is up and/or there is other feeding intolerance.

With the little ones we'll usually check residuals when they're starting on trophic feeds ..... checking mainly for color.