how to suction a NG feeding patient who aspirated

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I'm working on Saunders' book and came upon this question, a patient receiving NG tube feeding is experiencing stress and you suspect that she aspirated the feeding content. The answer is to suction. Just wonder how you suction this patient...my brain is blank now. thanks.

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Specializes in Medical-Surgical/Float Pool/Stepdown.

OK, I love Trach's and used to work on a trauma floor before I started in the float pool so I'll give you my two cents but this is where hands on clinical time really helps a nursing student (and a new grad) out. Anybody that says skills can be taught after graduation has never precepted a new nurse before and watched them touch the sterile spike (repeatedly) on the IV tubing and not get nor notice that they just contaminated their supplies and need to get another tubing set and IV bag. This is the part about critical thinking and some hands on experience that will really help prevent the nurse from making a bad situation worse. Think about how you're taught in the lab to first give a couple of puffs of the ambu bag before you normally suction a pt. Then think about the concept of aspirating tube feeding into your lungs. Then quickly take into account the pts O2 sat and decide if you should ambu first or suction first...what would you do...would you follow what you were told to do in school or would change steps.... Sorry guys, posted from my phone and tried to make paragraphs ! ! !

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Specializes in Anesthesia, ICU, PCU.

14 French (the kind you would use for endotracheal suctioning) nasotracheally. Don't forget to lubricate and it definitely helps to have a trumpet. If the patient has a cough and gag this is especially effective. If not... they're probably in the ICU with an ETT.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

STOP THE FEEDING IMMEDIATELY! Suction any visible feeding in the oral cavity. Do not try to ventilate with a BVM you will just push more feeding into the lungs. Naso-tracheal suction the patient...call for help, stat portable CXR, O2 nasal prong and ABG's if indicated

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14 French (the kind you would use for endotracheal suctioning) nasotracheally. Don't forget to lubricate and it definitely helps to have a trumpet. If the patient has a cough and gag this is especially effective. If not... they're probably in the ICU with an ETT.

Thanks for the explanation. My question is how to ensure the suction tubing goes into the trachea instead of the esophageal? I know that when inserting a NG tube, you ask the pt to sip water to close the glottis. Can you explain the use of trumpet to ensure nasaotracheal insertion or is there a video/website explaining this? thanks again.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

A nasal trumpet is a simple rubber tube inserted into the nares to decrease the amount of trauma to the nasal passage with frequent suctioning. You don't necessarily aim for the lungs per say however you do need to clear the airway. You wait for the intake of breath place the patient in a sniffing position. You need to be very careful not to make the patient hypoxic or stimulate the vagal response and drop the heart rate. I usually take a breath myself before suctioning and know to let the patient rest in between suction attempts.

Why do you ask? Is this an assignment? There are plenty of You tube videos.

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Specializes in Medical-Surgical/Float Pool/Stepdown.

I read your post and was like "why not use the tracheostomy to suction"...duh because it doesn't mention one! I apparently added a Trach to my thoughts when reading which is yet another reason not to post after a night shift!!! Whoops...

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Specializes in orthopedic/trauma, Informatics, diabetes.

I am not sure how an NG tube pt could aspirate, granted I do not have a ton of experience with them for feeding (we end up with a lot of SBO/ileus), unless they were vomiting (?)

Is this a bolus feed or continuous?

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Specializes in Complex pedi to LTC/SA & now a manager.
I am not sure how an NG tube pt could aspirate, granted I do not have a ton of experience with them for feeding (we end up with a lot of SBO/ileus), unless they were vomiting (?)

Is this a bolus feed or continuous?

Patients can vomit or reflux with an NG tube which can then be aspirated.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I am not sure how an NG tube pt could aspirate, granted I do not have a ton of experience with them for feeding (we end up with a lot of SBO/ileus), unless they were vomiting (?)

Is this a bolus feed or continuous?

because of gastric contents in the abdomen, residual feeding, migration/malposition of the NGT and yes vomiting
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