PEG Tube to suction..

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I need some advice. I recently had a patient with an ileus. The patient was extremely confused and had a peg tube. When I informed to doctor of the KUB results, he ordered and NGT. Another nurse on the unit said you can use the PEG tube for suction. I personally did not feel comfortable obtaining the order so the other nurse did. I consulted and ER nurse and an internal medicine MD for advice. Both advised me the above was not reccommended. I feel that the bowel and gastric mucosa can become damanged and/or damage the peg. I need some advice! Please help!

How did they get a diagnosis from a Kidneys, Ureters and Bladder X ray and not a AXR?

KUB is an abdominal xray. The x-rays go through the same part of the body. :)

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Specializes in ER, IICU, PCU, PACU, EMS.

I've done it once, but that was in the ER and to LIWS.

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How did they get a diagnosis from a Kidneys, Ureters and Bladder X ray and not a AXR?

Also never seen a peg to suction. Gravity yes with orders for in the bed or hanging lower on the cot sides. With or without 4 hourly aspirates.

KUB is a one view xray of the abdomen capturing the kidneys, ureters, and bladder. An abdominal xray is typically a 2 view or 3 view depending on the r/o for obstruction. You can diagnose obstruction of the bowel on a KUB but multiple views should be done if a bowel obstruction is suspected.

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Specializes in Critical Care.

I've only seen it once, but then again I've only had one patient who happened to already have a PEG and who also happened to have an ileus requiring relief by by suction. The GI doc in this particular patient was more than happy to use the PEG; it's already there why not use it, it's larger (22FR in this case) compared to our largest Salem Sump (18FR), and the way the tip of the PEG is positioned makes it less likely to damage stomach mucosa while suctioning compared to an NG, even on LIS. In this case there was no large solid matter coming through, otherwise an NG may have been preferable to avoid clogging the PEG.

Unless LIS just isn't sufficient to do the job, we usually don't use LCS even with a Salem sump.

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Specializes in ICU.

I've seen it. We had a pt who was intubated with a very distended abdomen. I don't remember the details, but we hooked his peg up to suction and was draising pretty heavily.

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Last week I heard other nurses talking about a peg tube to suction. I am still very new so I inquired and said that I had never heard of that before. The other nurse (also new) seemed as though it was completely normal, but I thought it was odd. Looking back on the situation I probably thought it was strange due to the reasons you mentioned, damage to the mucosa etc. From what I'm reading online it seems like a rare and short term occurrence.

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Specializes in Mental Health, Gerontology, Palliative.
If there's an order, then your butt is covered.....

Em nope. Just because a doctor ordered it doesnt mean it may be right or that a nurse wont get in trouble if they follow the doctors order. Case in point I had a situation where the doctor charted 300-600mcg fentanyl IV. It should have been 30-60mcg. The nurse gave 300mcg and just about killed the patient.

The nurse was very much in the firing line for giving the medication without checking the dose range.

Never assume just because the doctor has ordered it makes it right or safe.

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Specializes in ICU, LTACH, Internal Medicine.

PEG tube actually preferred for upper GI decompression. It is bigger and normally sits in stomach fundus - the thin-walled and easily blown-up part which can press against diaphragm and compromise respiration. It should be always under intermittent suction to prevent mucosa "suck in".

The problem is, it is not going to work for lower GI decompression, like Ogilvie syndrome, at all, and sometimes even not working well for the rest of upper GI like duodenum. But for stomach decompression PEG, if it is already in place, the way to go.

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Specializes in orthopedic/trauma, Informatics, diabetes.

Gravity drain to decompress sounds like a good idea. I just had a patient with very nasty ileus that was not a great pt to have an NG tube. I never really though about a pt with a peg having an ileus. We see so few on the ortho floor-PEGs not ileus We have the occasional ileus with hips and trauma of pelvis.

I love this site when questions like this come up! I think I would be ok with low intermittent sxn if I had orders for it. I will have to ask at work

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I have been researching if a feeding PEG should be used for suctioning and I have been told it is ok, but only in cases of abdominal trauma or bowel obstruction. Is this correct? Should a NG tube be placed for suction?

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Additionally, can you do low intermittent suctioning while tube feeding only only after tube feeding is complete?

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Specializes in Medsurg/ICU, Mental Health, Home Health.
Additionally, can you do low intermittent suctioning while tube feeding only only after tube feeding is complete?

If the patient has an obstruction, then tube feedings should not be administered.

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