Restraining patient with naso-gastric tube

[birdrecruit]

Our team is caring for a patient with anorexia who is fitted with a naso gastric tube for feeding. Problem is the patient keeps pulling the tube out. English statute allows us to restrain her to replace the tube and feed her but we are looking for an effective restraint method. With a normal patient we would use a "crucifix" restaint, laying her flat and staff would hold her arms out and still. Similarly someone would hold her legs together. However, lying flat would be dangerous when inserting an NG tube. Anyone experienced this. Can they suggest a safe method of restraint whilst the patient is sitting upright or at least at 45 degrees. Even though this lady is very frail she is amazingly strong.

[XB9S, BSN, MSN, EdD, RN, APN]

To clarify this , she would sooner have neither the NG tube nor food nor water - its a pretty desperate situation.

It sounds like a really difficult patient to nurse, I can't offer any advise about restraints as it is not something we use in general nursing I really admire your skills being able to deal with this

[birdrecruit]

It sounds like a really difficult patient to nurse, I can't offer any advise about restraints as it is not something we use in general nursing I really admire your skills being able to deal with this

Thanks for your support. I'll let you know how we go on.

[woody62, RN]

Reading the OP this lady is anorexic and under the mental health act which in the UK means that they are allowed to perform interventions in her best interest even without consent. I imagine she is pulling the tube because she is trying to refuse treatment

I once had a 15 year old suffering from anorexi. She pulled her ng tube out just once. We made it very clear to her that it would be reinsterted each time she yanked it out. She never yanked it out again. Truely, having an ng tube inserted ranks right up nesxt to being entubated while you are still awake-something I also experienced once and only once. No matter how much I knew the need for my ng tube, it didn't make it any easier to co-operate with its insertion. I am really not joking, it feels like a garden size hose being inserted down your thoart. And I didn't enjoy it nor was I able to cooperate one tiny bit.

One of the other least enjoyable things of my stay last July, was the insertion of an aterial line into my jugler artery. I suffer from a mild form of tartive dsykensia(?). The attending kept yelling at me not to move my jaw. And I kept trying to tell her I had no control over the movement. Unfortunately, too late in my career I have learned all the nice little things we tell patients, when inserting tubes into them, is just not nice and certainly none of those tubes feel little. They all felt huge like the size of a garden hose or even a fireman's hose.

Woody:balloons:

[Altered]

Oh, good God! :imbar