what and why of suprapubic catheter

[Wave]

This could be a tough one (for me anyway). I'm in clinic tomorrow and have to flush a "supra pubic catheter". Just need some info on the what, why and how the title says. Is a Silastic a certain brand or maybe a technique?

While I'm here, what's a dobhoff

Thanks in advance for any and all help.

~Wave

[Daytonite, BSN, RN]

a suprapublic catheter is a plain old silastic (that's a brand name) foley catheter that has been inserted into the patient's bladder through a surgically made incision in the front of the abdomen, rather than through the urethra. for some reason, using the urethra was not feasible. either the patient has prostate or cancer problems, or has had some kind of bladder surgery. these catheters are treated just like any other urinary catheter except that it exits from the skin of the abdominal wall, so there is usually a clean or sterile dressing that needs to be kept in place over it. you will flush it just like you would a regular foley catheter.

http://www.nlm.nih.gov/medlineplus/ency/article/003981.htm

a dobhoff tube (again, another brand name) is a long slim, flexible ng tube that is specifically used for tube feedings. these tubes are radiopaque and the end of the tube has a small mercury weight at its distal end so it can easily be identified radiographically. the tubes are inserted using a flexible metal stylet. once this tube is in place, the stylet is removed and peristaltic action carries the mercury weighted tip farther down into the gi tract, usually past the pyloric valve of the stomach and into the duodenum. the removed stylet should be coiled, placed in a plastic bag and taped at the head of the patient's bed in case it needs to be reused by the doctor to re-insert or reposition the tube at a later time. once the tube is positioned where the doctor wants it, it is taped to the patient's nose and should be marked. feedings are then started by pump as they do not readily flow by gravity very well with these tubes due to their small lumens. the mark on the tube at the nose needs to be assessed frequently as it is one of your indicators as to the position of the tube. you also do the confirmatory tests of pushing a bolus of air into the tube and listening for the gurgle over the abdomen to confirm placement. with these tubes, if displacement is suspected, the doctor needs to be notified and an order for x-ray obtained to determine the actual placement of the tube in the patient's gi system. these tubes can clog up easily, so they are often flushed with various types of liquids to prevent tube feeding from building up on the inside lumens. we often used small amounts of carbonated beverages or cranberry juice (it's a little acidic) to keep these tubes patent.

i tried to find a photo of a dobhoff on the internet for you, but wasn't successful. perhaps someone else will have better luck.

when you are in the hospital try to find the hospital policy and procedures on these two tubes and print a copy of them for yourself to give you something to get a better understanding of them and their care.

[Wave]

As always, Daytonite, you are a fount of information. Thank you

~Wave

[VickyRN, MSN, DNP, RN]

i tried to find a photo of a dobhoff on the internet for you, but wasn't successful. perhaps someone else will have better luck.

here are two resources:

http://focosi.immunesig.org/dobhoff_tube.gif

http://www.icufaqs.org/ngtubes.doc