Sump tube

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I had a kid who was 6 days post surgery to reverse his ostomy. He was on the vent for 5 days (don't get me started on the nurse who had him for 4 days...she scares me a lot!) I had him day 6 post op. Nights had 40 output from his sump, and then I wound up having 160+cc from 7a-3p. I notified the MD of the large amount, and the color went from the lovely green, to clear to coffee grounds. Towards the end of the shift, I begin to get get fresher blood, not bright red, but still redder than coffee ground colored. I notified the NNP and was pretty much blown off. I was always taught that its was a fairly alarming situation. I also know that the sump was probably irritating his stomach, but it was still concerning to me. Should I have been that concerned? I didn't expect him to come running over, but being blown off didn't help my confidence any. One of our Neos did happen to walk by and ordered meds.

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Specializes in Neonatal ICU (Cardiothoracic).

They shouldn't have blown you off in any case....

How high was the suction pressure set? I often find that when a replogle starts to pull out blood/clots, that the suction pressure is set too high, which could cause gastric bleeding.

Usually if the kid is acting ok, I'll drop the suction to 30-40mmHg, irrigate the tube w/ a little NS, and call the neo/NNP to get a Zantac or Prevacid order, if it's not already in the TPN. It usually does the trick.

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Sxn was on 80 mmHg. I wasn't getting any clots, just thick stringy secretions that kept blocking up my connections. It may have been up against the wall, but that I don't know. We did get him some previcid and It should have been added to HAF the next day.

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Specializes in NICU.

Our protocol for replogle to LWS is sxn between 40-60, so that may have been your issue. I've definitely seen scary red blood come out when the sxn is too high and miraculously clear up once you drop it to 40-45.

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Specializes in Neonatal ICU (Cardiothoracic).

Yeah.... 80mmhg is WAY too high. That what your airway suction should be set on. If you need to set it that high to get aspirates, you need to start irrigating/manually gently aspirating the replogle with 1-2 cc NS every couple of hours.

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