Salem sump to intermittant suction?

[nursej22, MSN, RN]

I was assumed care at 3pm of a pt admitted with SBO who had a Salem sump NG tube connected to low intermittent suction. I questioned this as I learned that a vented NGT should be attached to continuous suction. the off-going nurse showed me the physician's order (a verbal order taken by the nurse before her). I noticed that only 80 cc of gastric contents had been aspirated over the previous 8 hours. The pt had hypo BT and denied passing flatus. I switched the suction to continuous, and ambulated the pt twice, the only ambulating she had done since admit the previous evening. By my shift end, the pt was passing flatus:nurse: and 400 cc of gastric contents was suctioned out.

I reported off to the night nurse (

I have never heard of this, nor can I find any evidence-based guidelines regarding this.

Has anyone else heard of this?

[iluvivt, BSN, RN]

The only thing I can think of is this. When you have upper GI losses including chloride you can have metabolic alkalosis. With the alkalosis you will usually see hypokalemia as the K+ goes intracellular and the Hydogen ion comes out of the cell to correct the Alkalosis.

[nursej22, MSN, RN]

But does decreasing the rate of gastric suctioning affect the serum K+ level? If digestive contents cannot move through the GI tract because of an obstruction, then then ions cannot be absorbed in the small intestine. Gastric decompression is meant to aid in the return of peristalsis so I am thinking the sooner things starting moving in the right direction, the sooner the gut can resume its normal functions.

[litbitblack, ASN, RN]

You also have to think what the suction can do to the inside of the stomach. If the suction is to much it can irritate the lining even going so far as causing bleeding. Have seen this happen

[BinkieRN, BSN, RN]

If the order was for intermittant suction then you should not have changed it to continuous without speaking to the doctor first.

[cherrybreeze, ADN, RN]

The vast majority of our NG's are ordered to low intermittent suction. There is one surgeon that will order low continuous, but he also orders scheduled irrigating of the tube.

It should not have been changed without an order....they have a reason for ordering it the way they did.