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OG Tubes after Intubation - suction

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by Genavina Genavina (New Member) New Member

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After an OG tube is inserted in an intubated patient, when and how do you connect to suction? After radiology confirmation? Low intermittent? Do you do this for all intubated patients?

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Nalon1 RN/EMT-P has 2112 years experience and works as a Nurse.

10,663 Visitors; 765 Posts

NG/OG tube placement verification will vary by facility.

Where I am, all intubated patients need a gastric tube hooked up to intermittent suction unless contraindicated (bariatric surgery pts primarily) or direct physician order. We are allowed to hook up suction after insertion with auscultation/aspiration verification, but they do want radiological confirmation at some point.

And just a pet peeve, I hate OG tubes. They are harder to secure (they should not be secured to the ET tube or any ET tube securement devices) and when a patient is extubated, you have to remove the OG tube, and if they are on tube feed or still need the gastric tube, you now need to put a NG in (while they are now awake vs when intubated they were more than likely unconscious or at least heavily sedated).

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RookieRoo works as a ICU RN.

4,747 Visitors; 234 Posts

We hook up right away, but no feedings until confirmed placement via radiology.

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MYSTICOOKIEBEAR has 5 years experience.

3,541 Visitors; 144 Posts

Have the suction tubing ready to go, once you auscultate and verify it's position is gastric in nature, connect the suction tubing to the OG/NG to LIWS (Low Intermittent Wall Suction). If you are going to give any medication or administer any feeds MAKE SURE to have radiographic confirmation with an abdominal xray that is read by a radiologist, cleared by your MD, and that the order "Okay to use" is in. Always make sure to CYA and do things by the book.

I automatically insert an OG/NG for all of my recently intubated patients just to prevent aspiration and to administer meds UNLESS the patient had an esophagectomy, lung transplant, other upper GI surgery, or unless otherwise contraindicated (already has a DHT with loose BMs, has an G tube or J tube with regular BMs etc).

Since we are talking about intubated patients, I recently made a video about ICU Nurse's role in endotracheal intubation in the critical care setting that might help you out as well. Hope this helps, cheers! :wavey:

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sissiesmama has 22 years experience and works as a RNC.

21,540 Visitors; 1,893 Posts

NG/OG tube placement verification will vary by facility.

Where I am, all intubated patients need a gastric tube hooked up to intermittent suction unless contraindicated (bariatric surgery pts primarily) or direct physician order. We are allowed to hook up suction after insertion with auscultation/aspiration verification, but they do want radiological confirmation at some point.

And just a pet peeve, I hate OG tubes. They are harder to secure (they should not be secured to the ET tube or any ET tube securement devices) and when a patient is extubated, you have to remove the OG tube, and if they are on tube feed or still need the gastric tube, you now need to put a NG in (while they are now awake vs when intubated they were more than likely unconscious or at least heavily sedated).

I hate OGs too!!

Anne, RNC

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Magsulfate has 13 years experience and works as a RN.

13,794 Visitors; 1,201 Posts

I concur also. Unless the Nasal passages are obstructed, go for the nares.

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canoehead has 30 years experience as a BSN, RN and works as a RN ER.

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I'm in the ER, and always assumed there was a reason the ICU wanted an OG for vented patients. An NG is fine too? It would be easier to secure for me, and away from all the oral secretions.

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Wile E Coyote works as a critical care RN.

9,520 Visitors; 471 Posts

The preference of OG over NG tubes is due to the higher risk for sinusitis associated with NGT's (class IV recommendation...limited clinical studies showed correlation per the last time I looked it up in the AACN procedure manual)

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Lev has 7 years experience as a BSN, RN.

2 Followers; 8 Articles; 55,348 Visitors; 2,799 Posts

We automatically hook up to LIS suction before the xray and after auscultation. We go for OG but will try for NG if unable to get an OG. NGTs are harder to get in when your patient is not sitting up straight or able to tuck their chin.

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Maevish has 9 years experience and works as a RN.

9,588 Visitors; 396 Posts

I've also usually done the CLWS or ILWS (and a lot of the time the doctor will order it), but it depends. 8 times out of 10, though, they get the suction right away. Some hospitals let you confirm placement by auscultation, but some make you do an XRAY or check the pH of the suctioned matter before feedings are started.

xo

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jj224 has 4 years experience and works as a SRNA.

6,999 Visitors; 363 Posts

We used to put in OGT immediately following intubation. That way, when x-ray comes to do the CXR we can have them do a KUB quickly that the fellow could see right away - makes it easier if we need to do feeds later. If not with intubation, I'd just hook it straight up to suction and make sure it's known there hasn't been x-ray confirmation of placement in case someone wants to use it for feeds.

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13 Visitors; 2 Posts

Where do you secure the OG tube if not to the ET tube?

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