Tap water

WSU_Ally_RN, BSN, RN · Aug 5, 2009

The gut is not a sterile environment, so no need to use sterile fluids. I suppose you could use saline, but you need to do what ever your facilities policies and procedures tell you to do.

PAERRN20 · Aug 5, 2009

Saline has more sodium compared to tap water which can be problematic for certain patients.

rn/writer, RN · Aug 5, 2009

Using ns may seem to make sense because you're doing something "medical," but you have to take your thinking a step further. The "g" in ng tube stands for gastric, meaning that the fluid is going into the stomach. Those of us who can take in food and fluids in the usual manner drink tap (or bottled) water, not salt water (aka saline). So, why would you put salt water or ns into the stomach of someone with an ng tube?

It might not harm them as it is isotonic with the rest of the body's fluids, but it simply isn't necessary.

CABG patch kid, BSN, RN · Aug 5, 2009

Another reason would be that in people who are getting tube feeding, the feeding itself is a hypertonic solution, and when you add tap water, which is hypotonic, it balances it out. The tap water dilutes the particles in the tube feeding formula. Also, the tube feeding doesn't have enough fluid itself to keep a person hydrated, that is why a lot of long-term care people on tube feeding get dehydrated: not enough free water down the peg tube. Just an aside, but another reason to use plain water.

WhiteLily · Aug 5, 2009

Thank you all for the good answers!

talaxandra · Aug 5, 2009

Always keep the site as well as the kind of therapy, in mind. That way you, unlike one of our grads, will avoid flushing a PICC for TPN with tap water. A little OT but the error happened because she was thinking of the point of the intervention (feeding) and not the route (intravenous).

WhiteLily · Aug 5, 2009

Great point to remember! Thanks.

CABG patch kid, BSN, RN · Aug 5, 2009

Always keep the site as well as the kind of therapy, in mind. That way you, unlike one of our grads, will avoid flushing a PICC for TPN with tap water. A little OT but the error happened because she was thinking of the point of the intervention (feeding) and not the route (intravenous).

Wow. Blaming the intervention (that is was a feeding) is no excuse for this. That's a perfect example of a person who didn't ask a question when she wasn't sure of something.

PAERRN20 · Aug 6, 2009

Always keep the site as well as the kind of therapy, in mind. That way you, unlike one of our grads, will avoid flushing a PICC for TPN with tap water. A little OT but the error happened because she was thinking of the point of the intervention (feeding) and not the route (intravenous).

So what happened to the PICC line that got flushed with tap water? Eeeek!!!

talaxandra · Aug 6, 2009

Sadly it was less a case of not asking a question than one of being both ignorant and frighteningly over-confident. It was reported by the (alert, oriented, reliable) patient - initially she denied having done it but then admitted it, without seeming to have any concept about the risks of what she did.

She had remedial medication education and a mandatory IV/CVAD course, and is not allowed to single-check, but is still unbelievably overconfident in her abilities - from 6 months in she was saying she had learned everything there was to know about our six specialties and needed more of a challenge, but ICU will not take her without a NUM referral and that will never happen so she is part time with us and working elsewhere as well.

The patient was put on a prophylactic course of antis and amazingly suffered no ill effects. He was also told that if he ever has concerns or questions about what someone is giving him or doing he not only can but should stop them and check first. Better a 5 minute delay than a life-threatening infection!

PAERRN20 · Aug 6, 2009

Wow so scary! That poor patient!