Sterile water to flush feeding tubes?

[nursesky]

Why do we use sterile water to flush feeding tubes such as the j-tube? What happens if we use normal saline instead? I understand that sterile water is hypotonic and fluid will shift into the cells. NS is isotonic. On another note, I learned to flush NG tubes with NS. Why is there a difference in flush solutions if we are still instilling both into the GI tract?

[CelticGoddess, BSN, RN]

The policy at my facility is to use tap water, and it is not going into a sterile field but into the GI tract. I've never been taught to use clean water or saline. 

[Okami_CCRN, BSN, RN]

I flush feeding tubes with tap water as the gut is not sterile unless the patient is immuno-compromised. Occasionally surgeons will request an NS infusion through a J-tube/G-tube to maintain patency at around 20ml/hr for about 24 hours.

[Libby1987]

Saline in the gut?

We use tap or bottled. (Home health). I'm unsure if some tap water can cause residue if too high in certain minerals.

[NPOaftermidnight, MSN, RN, NP]

Here is a recent similar discussion:

https://allnurses.com/sterile-water-enteral-feeding-tubes-t610144/

I have never flushed an NG/NJ/OG with saline. Nor have I heard of anyone doing this.

[nursesky]

On the unit I am on for clinical, the policy is to use sterile water. Tap water makes sense since the GI tract is not clean. But why do we use water (sterile or tap) to flush them? What happens if we use normal saline? That is my question.

[TheCommuter, BSN, RN]

nursesky said:

But why do we use water (sterile or tap) to flush them? What happens if we use normal saline? That is my question.

Normal saline is isotonic, and it has a similar composition to blood. It is inappropriate for the GI tract due to lacking the osmotic gradient for proper absorption across the intestinal endothelium.

So, if the normal saline is flushed as one bolus (and it usually is), it will work like a saline laxative in the patient's system. Read: patient will have loose stools.

[nlitened]

The policy at one of the hospitals I did clinical was that if it was new.

This sounds like perfect research into current Evidence-Based Practice for gastric tube flush medium.

A site like EBSCO, CINAHL, PubMed, etc., would be a great place to start.

Typically, it takes over a decade for current EBP to be incorporated into practice.

Be a leader, and find out from a few high level-of-evidence articles what the standard should be.

[BuckyBadgerRN, ASN, RN]

I've never used sterile water to flush a tube. We don't drink clean water!

[BuckyBadgerRN, ASN, RN]

Are you still in school? What do your instructors say, nurses?

nursesky said:

On the unit I am on for clinical, the policy is to use sterile water. Tap water makes sense since the GI tract is not clean. But why do we use water (sterile or tap) to flush them? What happens if we use normal saline? That is my question.

[~PedsRN~, BSN, RN]

Would you want to drink saline? ?