Gastro-Intestinal Tubes

Front 1

Blakemore Sengstaken Tube

Back 1

used for someone who has esophageal varices -- back flow of stuff in the liver
- can be placed through nose or mouth

Front 2

decompression feeding:

Back 2

suction out contents of stomach - fluid or air

Front 3

varicos veins:

Back 3

enlarged veins and bulge out, everyonce in a while, they rupture (if they rupture, patient will hemorrhage)

Front 4

lumen:

Back 4

at the end of tube

Front 5

cantor tube and miller abbott tube

Back 5

both go in small intestine

Front 6

NEX ==

Back 6

nose, earlobe, xyphoid process

Front 7

three things to check placement of NG tube

Back 7

1. aspirat stomach content with large end syringe
2. insert bolus of air and listen for sound in LUQ
3. check gastric ph of 4 or less -- acidic

Front 8

if stuff other than air is coming out of air vent, then need to:

Back 8

IRRIGATE

Front 9

intermittently irrigate tube to maintain:
and then...

Back 9

patency

--aspirate after irrigation
if aspirant is less than irrigant = output
if aspirant is greater than irrigant = intake

Front 10

when discontinuing an NG tube:

Back 10

patient needs to hold breath, so make it snappy!
-remove tube into a towel

Front 11

Feeding tube -- DOBB HOFF

Back 11

36" (pink) for gastric
43" (green) for duodenal - has wire, take it out once in patient after x-ray
55" (brown) for jejunal

Front 12

PEG or Jejunal --

Back 12

surgically inserted feeding tube
Percutaneous Endoscopic Gastrostomy

Front 13

Gastric placement-

Small bowel-

Back 13

NEX + 2 cm

NEX + 25 cm

Front 14

Checking for airflow

Back 14

as the patient exhales, dip the tip of the stylet into a cup of water. if bubbling occurs pull the tube back into the oropharynk and start again. if no bubbling occurs quickly inject 20 ml of air and watch to see if patient burps. REMOVE tube from H20 before patient inhales (risk of aspiration)

Front 15

AUSCULTATION

Back 15

use a 60 ml syringe and draw up 60 ml of air. inject air into the tube in 15 cm air bursts while listening (with stethoscope) over the LUQ, epigastric area, RUQ, and RLQ (in succession)
-the sound should be loudest over the LUQ or Epigastric if gastric placement

Front 16

Vacuum effect:

Back 16

immediately after listening at the RLQ pull the plunger on the syringe back to the 40 ml mark and let go.
-if the plunger returns to <10ml mark, advance the feeding tube 5 cm and recheck
-air should easily be withdrawn from the stomach and when >30 ml is noted on release of plunger

Front 17

for duodenal placement... once you know you have gastric placement:

Back 17

turn patient on their right side. then advance the feeding tube an additional 25 cm while injecting 5-10 ml bursts of air. then rotate the tube in a clockwise direction as you advance to the 75 cm mark.