Salem Sump NG Tubes

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Hi,

Had a bad time with these things the last few days and wanted to get more info on them. Had a doc tell me about relying on flushing the anti reflux valve with air to determine placement as opposed to relying on the x-ray. would have liked to have asked much more, but was getting my butt kicked at the time ( sure you all know that story), so would like a quick inservice from people much more familiar with them. appreciate your help.

Specializes in Med-Surg, Long Term Care.
heartICU said:
(As a side-note, the anti-reflux valve has air vents in it to allow for air to move in and out, but it also prevents the stomach sludge from coming up).

Here's a picture of the valve we have on our Salem Sump tubes:

Salem Sump Tube

We don't even check the pH of gastric fluid at my hospital, let alone getting an Xray. We just check for placement with air installation. I think I'll give our Nurse Educator a call...

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RN-PA said:

Here's a picture of the valve we have on our Salem Sump tubes:

We don't even check the pH of gastric fluid at my hospital, let alone getting an Xray. We just check for placement with air installation. I think I'll give our Nurse Educator a call...

If your using a salem slump for suction a CXR isn't necessary....You can use air bolus with two nurse verification and pH testing....But if you are using it for feeding, or any tube...You should always do a CXR.

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Specializes in Med/Surg, Ortho.

We find the main reason for stomache contents to flow back into the air vent is because people tend to want to use the vent end to plug the ng tube when they ambulate a patient. I have found many of the vent tubes with stomach contents after a CNA walked a patient with a little investigation ive found they dont know not to use the vent to plug the tube when they disconnect the patient. They are told to plug the ng and ambulate the patient and think thats what the white end is for.

I always make sure i use a three-way stopcock on the ng tubes now, it stops the confusion and they dont misuse the ng tube vent.

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Specializes in NICU.

We use Salem Sumps and Repogles all the time in the NICU. I was always under the assumption that the air port needs to be unplugged at all times. Even when we disconnect suction and leave the tube to gravity or racked, we leave it open. If there is gastric contents creeping up the air port, I always flush that port with a few CC's of air (never water) to get rid of it, and suction gets restored. If it keeps happening, I'll change the tube if possible. At our hospital we don't check placement with X-ray or pH paper, just auscultation of air. Uusally if a patient need a sump tube, they've got a stomach full of junk so it's pretty obvious if the tube is in or not.

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Specializes in Med-Surg.
jaimealmostRN said:
New grad warning here, this is just what I remember reading about Salem sump. The blue vent should always be open, esp. if on suction b/c it prevents the tube from sucking the stomach lining and damaging it. If the blue tube is draining (which it shouldn't be) you can flush with air (not sure about water) to get the suction back on track - coming out the clear tube. I think the only time the blue can be tied off, is if the salem sump is not being used for suction at the present time. My $0.02 ?

I agree, that's how I learned, and how I practice. As part of my assessment after I've checked placement, given meds, etc. as a practice I instil about 100 cc of air in the antireflux valve, just to make sure it's clear and off of the stomach lining. Don't remember where I learned that, or if I made it up, but it's just something I do on all of them during my assessment. ?

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Specializes in Surgical.

Our anti-reflux valves are blue on the vented side and white on the other. You may use the white side to block the tube since air does not flow this way and the blue side should be inserted into the air vent to allow air flow. Any tube that is to be used for feedings or instilling anything but air should be checked for placement by CXR. It would not be cost effective to xray NG placement for an ileus when you received return of 1000mls of stomach contents!

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We use an anti-reflux "valve" where I work as well. The sad thing about many different "valves" is that they aren't REALLY one way valves, they are filters that allow air to go in AND out of the NG so Stomach contents still can back up your air-port(blue pigtail), then the filter part gets dirty and nothing can get through in any direction and you have to replace the "valve" if you want your NG to continue to work well.

The good thing is that we are hoping to trial a NEW NG that has a REAL one way valve, and has a built in medication port that you can switch to to administer meds by turning a dial and then turn back to suction when you're ready for that.

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Specializes in i am still student.

i want anybody to send to me a research paper about salem sump tube

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A lot of the time if gastric liquid is coming from the blue port it is because the suction isn't working correctly and the stomach is full. Check EVERYTHING from the canister lid, to the suction regulator, to the tubing, there is probably a leak somewhere. Another reason it leaks out the blue port is because someone has flushed the NG using the blue port. the blue port is just for air. I'm not sure why that is but it does cause it to leak.

Michelle

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RN-PA said:
An Xray is REQUIRED by JCAHO??? You've got to be kidding. I'd love to know if anyone else has heard this!

I never and we just got JCAHO'ed!

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Please can you help on this. I am just starting this course.

Can you please tell me more about Levine and Salem Sump nasogastric tubes?

Also which tube (Levine and Salem sump) can be attached to continous suction. I have no idea, I can't find in the book.

Thank you so much in advance.

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Specializes in ER, ICU, Infusion, peds, informatics.
tseten said:
Please can you help on this. I am just starting this course.

Can you please tell me more about Levine and Salem Sump nasogastric tubes?

Also which tube (Levine and Salem sump) can be attached to continous suction. I have no idea, I can't find in the book.

Thank you so much in advance.

Theoretically, the salem sump can be hooked to continuous suction.

The blue port is supposed to keep the tube from sticking to the wall of the stomach, which is the main danger of continuous suction.

However, most facilities (where I've worked; not sure about the others) and many physicians prefer all NGTs to be to intermittent suctions still.

This is probably because the blue port tends to get clogged, and thus malfunctions sometimes.

I learned somewhere that when the blue port is functioning, the suction needs to be set to "medium" for optimal function. I think I learned that in school, but it has been a while so I'm not sure anymore.

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