This document discusses various types of gastric tubes including Salem sump tubes, Levin tubes, Moss Mark IV tubes, Miller-Abbott tubes, Sengstaken-Blakemore tubes, PEG tubes, and J-tubes. It provides details on their uses, placement, care, and contraindications. Guidelines are provided for enteral feeding administration and maintenance as well as parenteral nutrition indications and considerations.
ENDOTRACHEAL TUBE INTUBATION II Parts II Details II Clinical DiscussionSwatilekha Das
What is endotracheal intubation?
Endotracheal intubation is a procedure by which a tube is inserted through the mouth down into the trachea (the large airway from the mouth to the lungs). Before surgery, this is often done under deep sedation. In emergency situations, the patient is often unconscious at the time of this procedure.
For detailed information plz watch the slides till end.......
And plz like, share and comment and follow......
ENDOTRACHEAL TUBE INTUBATION II Parts II Details II Clinical DiscussionSwatilekha Das
What is endotracheal intubation?
Endotracheal intubation is a procedure by which a tube is inserted through the mouth down into the trachea (the large airway from the mouth to the lungs). Before surgery, this is often done under deep sedation. In emergency situations, the patient is often unconscious at the time of this procedure.
For detailed information plz watch the slides till end.......
And plz like, share and comment and follow......
A brief awareness and knowledge about the insertion of NGT nasogastric Tube and feeding through it.
It contains an introduction, procedure, equipment needed, method of feeding etc
This presentation will give an overview of what NG tube is, types of NG tube, indications and contraindications, how to insert NG tube and potential complications of NG tube
COLONOSCOPY- A PICTORIAL OVERVIEW
• Dear viewers,
• Greetings from “Surgical Educator”
• This week I have uploaded a video on Colonoscopy- the Lower GI Endoscopy.
• In this episode, I showed only the colonoscopic features of common pathologies in colon and rectum.
• I restricted my talk to the essential minimum that an undergraduate medical student must know about the Colonoscopy.
• I discussed about the diagnostic and therapeutic procedures you can do with the Colonoscopy.
• I hope it would be interesting and very useful to all my viewers.
• You can access this video in the following links:
• surgicaleducator.blogspot.com youtube.com/c/surgicaleducator
• Thank you for watching the video.
A brief awareness and knowledge about the insertion of NGT nasogastric Tube and feeding through it.
It contains an introduction, procedure, equipment needed, method of feeding etc
This presentation will give an overview of what NG tube is, types of NG tube, indications and contraindications, how to insert NG tube and potential complications of NG tube
COLONOSCOPY- A PICTORIAL OVERVIEW
• Dear viewers,
• Greetings from “Surgical Educator”
• This week I have uploaded a video on Colonoscopy- the Lower GI Endoscopy.
• In this episode, I showed only the colonoscopic features of common pathologies in colon and rectum.
• I restricted my talk to the essential minimum that an undergraduate medical student must know about the Colonoscopy.
• I discussed about the diagnostic and therapeutic procedures you can do with the Colonoscopy.
• I hope it would be interesting and very useful to all my viewers.
• You can access this video in the following links:
• surgicaleducator.blogspot.com youtube.com/c/surgicaleducator
• Thank you for watching the video.
A blended approach to training Registered Nurses in Nasogastric Tube Insertio...Henry Fuller
This presentation was delivered by Henry Fuller at the 2014 Show and TEL event hosted by Health Education England and the Higher Education Academy. It discusses the benefits of using e-Learning as part of a blended approach to deliver the theoretical knowledge required for nasogastric tube insertion and ongoing care for adults. It also gives best practice guidance for different approaches to instructional design.
Enteral feeding is a narrow feeding tube is place through nose down it to stomach. This tube is used to give fluid, medication and liquid food complete with nutrients directly in to stomach.
#ppt on Enteral Feeding, #Enteral Feeding
2. Salem (Double Lumen) pump
• Most common nasogastric
tube
• Used for irrigation of stomach
and tube feedings
• Sizes 14-18 French
• 120 cm long
• If suction is needed, connect
the larger bore to suction
• Blue vent is always open to
air for continuous
atmospheric irrigation
• Prevent reflux by having the
blue vent port above patient’s
waist
3. Single Lumen Tubes
Levin
• Sizes 14-18 French and 125
cm long
• Used for stomach
decompressing, withdrawing
specimens, washing the
stomach free of toxic
substances, and irrigating the
stomach and treat upper GI
bleeds
• Can be used to administer
meds and/or feedings
4. Dual-Purpose Tubes
Moss Mark IV,
Dobbhoff Nasojejunal
• Inserted nasally and ends in the
duodenum or jejunum
• Gastric decompression port
connects to suction
• Use the smaller, more distal
port, for feedings
• Reduces reflux through
removing excess feedings
• 3rd port is a retention balloon
5. Double-Lumen Nasointestinal Tube
Miller-Abott Tube
• Rubber balloon tip that
should not be inflated until
passed through the pylorus
• Peristalsis moves balloon
along
• Second port is for suction
for sampling
• Label the ports to alleviate
confusion
6. Tubes for Upper GI Bleeding for Varices
Sengstaken-Blakemore
• Two lumens inflate the
gastric and esophageal
balloons
• 3rd lumen reserved for
gastric suction or drainage
• Can be inserted orally or
nasally
• Compresses esophageal
varices or reduce
gastrointestinal hemorrhage
7. Percutaneous Endoscopic Gastrostomy
(PEG) Tube
• Procedure for placing a
feeding tube directly into the
stomach through a small
incision in the abdominal
wall
• Peg tubes can be temporary
or permanent
• Peg tube care should be
completed every 8 hours
with part hydrogen peroxide
part sterile water, then place
a drainage sponge around
port
8. J-tube
• Placed in the jejunum
• Lasts >= 30 days
• Decreases risk for reflux
• Decreases risk for
complication in
comparison to Peg tube
• Can be a combo of J/G
tube
9. CONTRAINDICATIONS FOR NG
TUBE PLACEMENT
•Mid-face trauma
•Recent nasal surgery
•Esophageal perforation
High Risk
• head/brain trauma
•Deviated septum
•Esophageal varices/strictures
•Recent banding/cautery of varices
•Coagulation abnormalities
•Alkaline ingestion
•Nasal polyps
10. Questions
• You have a patient that needs gastric suctioning
and may need feedings after a few days post-
op. Which tube would you most likely use?
Salem sump gastric tube
11. Can you close the vent, blue, port
on a salem sump tube?
No, the ventilation port should not be closed off. To ensure this, you can use an anti reflux valve
(seen above) as long as it is positioned correctly to allow air to circulate or a syringe without a
plunger to guarantee the ventilation port remains higher than the patients abdomen.
12. Enteral Nutrition Indications
• Patients unable to eat due to surgery, injury,
or disease like mechanical ventilation,
comatose, and head and neck surgeries
– Post-CABG, MVA head traumas
• Nutritional deficits from reduced food
ingestion or malabsorption
– Low albumin, decrease appetite
• Impaired gag or swallow reflexes
– Stroke, tracheostomy patients
13. Enteral Feeding Administration and
Maintaining Tube Patency
• Initiation after tube feed placement checked
– Start at 10-40mLs/hr
• Progression to goal
– Increase by 10-20 mLs every 8-12 hrs
– Critical care/greatly malnourished
• Increase by 10 mLs every 12-24 hrs
• Flush tube with 20-30mLs every 4 hrs
– Before and after intermittent feedings
– 10 mLs before and after each medication administration
– 30 mLs before and after each residual check
14. Patient/Family Education for Feedings
• Stay upright if tolerate
during and after feedings
– Pause if Head of bed is less
than 30 degrees
• Fullness, increased gas,
belching, or diarrhea is
common
• X-rays will be completed
to ensure placement after
placement
• Use of a lopez valve or
leur-lok system during
feedings is preferred
• Absent bowel sounds are
not a contraindication to
feedings
• Residuals cannot be
checked if jejunum or
duodenum is accessed by
tube
• Immunocompromised or
critically ill patients
should have sterile water
flushes.
15. Nursing considerations for feeding
• Tube feeds should be at
room temperature
– Liquids not room
temperature can cause
gastric cramping and
discomfort
• Shake tube feed well
• Gastric residuals greater
than 500mls can cause
aspiration
• Change tubing and tube
feed bags a minimum of
every 24hrs
• Blood sugar checks should
be a minimum of every 6
hours
• Check gastric residual
before each feeding and
every 4-6 hours initially
for continuous feedings
for 24 hours, then every 6-
8 hours
– Once small bowel feedings
tolerance, there is no
benefit to performing
residual checks and will clog
the tube
– If residual is high, then
intestinal tubes may be
dislodged
– Enteroflexes are unable to
check residuals due to the
density of the tube
16. Parentral Nutrition (TPN)
Indications
• Bowel rest
• Nonfunctioning GI tract
• Severe malnutrition in
which the patient does not
eat for 5 days or more
Contraindications
• Treatment of < 5 days
without malnutrition
• No IV access
• Functioning GI tract
17. Parentral Nutrition (TPN)
• Peripheral Nutrition
– 10-14 days without fluid
restriction
• Central Nutrition
– Long-term, fluid
restriction, poor
peripheral access
• Bags last for 24 hours
and a new order must be
placed by 1800 for
pharmacy to have for
patient
• Complications
– Abnormal labs, fatty liver,
GI atrophy, catheter
complications
• Transition slowly to po
diets
– Decrease TPN volume by
half every 1-2 hours
• Maintain TPN
– If TPN continuing without
next bag present, start D10
to maintain blood sugar.