Securing OGTs

[millyk30]

I need some suggestions on how to secure OG tubes with babies on NCPAP. My unit is currently using NG strips, but they are constantly getting wet from the CPAP and oral secretions and causing the tubes to become too shallow or come out. Does anyone do something differently? Anyone secure them somehow to the CPAP hat? Thanks.

[elizabells, BSN, RN]

I think all the tubes are like that - they all have holes along the side but the end is rounded so insertion is easier and so it doesn't dig into the stomach. But there might be differences between companies where some have holes much closer to the bottom of the tube while others are further up, you know? We should all measure them and get back to each other.

Well, as I'm not on the unit for now I can't measure, but the green ones have holes very close to the ends, IIRC. Also, at least on my unit, we aspirate those suckers pretty hard. Wonder if it's hurting the little one's bellies. We've had kids, like with minor heart defects, on their LAST day, right before discharge, mom has learned to pass the tube, suddenly start acting sick and bam, they've got NEC.

[lovemyjob]

Well, as I'm not on the unit for now I can't measure, but the green ones have holes very close to the ends, IIRC. Also, at least on my unit, we aspirate those suckers pretty hard. Wonder if it's hurting the little one's bellies. We've had kids, like with minor heart defects, on their LAST day, right before discharge, mom has learned to pass the tube, suddenly start acting sick and bam, they've got NEC.

Something happens when a kid gets ready to go home....almost like they hear us talking about it...

We used the green ones in our nursery when a kid needed some fluid pulled off of the stomach. We would have to be careful about it. I would notice that when I pulled too hard there would be blood in the tube when I pulled the tube out (there werent left in.) One girl also pulled so hard/much that she caused the baby to bleed for a while after she finished and even threw up blood. Not sure what happened after that, but I always try and be really careful.

[elizabells, BSN, RN]

Something happens when a kid gets ready to go home....almost like they hear us talking about it...

We used the green ones in our nursery when a kid needed some fluid pulled off of the stomach. We would have to be careful about it. I would notice that when I pulled too hard there would be blood in the tube when I pulled the tube out (there werent left in.) One girl also pulled so hard/much that she caused the baby to bleed for a while after she finished and even threw up blood. Not sure what happened after that, but I always try and be really careful.

Yeah, I've gotten blood a couple times too. Just a little, though, and never had bloody vomit afterwards. I was taught to aspirate ALL the air out, until I basically couldn't pull the syringe back anymore. I've started stopping a bit before that since I saw blood the first time. I mean, that CAN'T be good.

[Gompers, BSN, RN]

Something happens when a kid gets ready to go home....almost like they hear us talking about it...

Oh, I know! You can NEVER say it out loud. We'll spell it out instead. "Baby Smith is doing great, PO AD LIB, going H-O-M-E tomorrow but don't you DARE tell him..."

One mom used to call going home "going to church" instead. She'd say, "Oh, he's doing really great. The doc says he can go to church on Tuesday if his eye exam goes well..." and my coworkers would be freaking out. "She's taking that preemie on oxygen to CHURCH?!?! With all those PEOPLE?!?!"

Thinking about the tubes more...

I do remember two babies that were transported to our unti from other hospitals because they had stomach perforations due to NG tube placement. One had a green tube, and one had an orange tube. I'll never forget it. They thought both had NEC. Being community hospitals, they didn't have Repogles or Salems to place to suction, so they just left the NGs in and aspirated from time to time until we got there.

We use the blue Arglyes, too. Very very soft. I avoid using the 8 french at all costs, though, because it does get a but more stiff at that size.

[prmenrs, RN]

I would be very gentle when aspirating an NG tube.

Back when we used NJ tubes, I once check for resistance (not a "snap") and got 3 mls of pure blood--like I'd hit a vein!!! Scared hte heck outta me! "hey, doctor, Doctor, HEY, DOCTOR!!!"

[lovemyjob]

I would be very gentle when aspirating an NG tube.

Back when we used NJ tubes, I once check for resistance (not a "snap") and got 3 mls of pure blood--like I'd hit a vein!!! Scared hte heck outta me! "hey, doctor, Doctor, HEY, DOCTOR!!!"

SCARY!!!!