What type of tube would be used to lavage a patient's stomach?
What are some reasons as to why we would perform gastric intubation
emptying or lavage of the stomach, short term nutrient admin or admin of gastric soln (Barium)
What does it mean to lavage?
To admin fluid and siphon fluid back; so the substance will linger then leave the body with stomach contents
Feeding through the use of a tube. Admin only- not siphoning contents back, admin food but not force feeding.
With or by way of intestine.
Where does enteral feeding deliver nutrients to?
Directly to the stomach, duodenum, or jejunum
via the oral cavity. mouth to stomach.
What is the best feeding route with a tube if there are no contraindications?
What is the trade name of Activated Charcoal?
What is activated charcoal used for?
Absorbing ingested toxins.
How do you measure for a gastric tube?
measure from tip of nose to 13th rib.
what is the reason for measuring the gastric tube?
to make sure you're actually within the lumen of the stomach
What can happen if a gastric tube is inserted too far into the stomach?
Perforation of stomach. Tube can hit stomach wall and twist around and come back up esophagus
Is sedation needed for orogastric tubes? Explain.
Dogs- no- if patient does well and only to relieve gas or admin barium. if patient needs food or toxins removed then sedation needed
cats- sedation always needed.
Why do we not want to perform gastric lavage on awake patients?
they can aspirate the fluid being lavaged and could cause aspiration pneumonia.
What is the purpose of endotracheal intubation?
Provide an airway for admin of O2 and anesthetics; to prevent aspiration of fluids.
Where are you normally able to palpate the tube during gastric intubation?
Cervical region, dorsal to the trachea.
How can you check to see if gastric tubes are correctly placed into the stomach?
Inject 5-10 mls of air into tube and ascult cranial abd. if gurgling sounds present, tube is in GI tract. Can inject 5 mls of saline into tube and if patient coughs tube incorrectly placed. Also can radiograph.
How many times should gastric lavage be repeated before removing tube?
what must you do to the gastric tube before removing the tube and why?
double kink the tube to avoid spilling from tube into trachea, helps avoid aspiration
During recovery from anesthesia after gastric lavage, what is the main thing we need to monitor for?
V+, can lead to more aspiration
What is an OGT?
What is an NG?
What is an NE?
What are some indications for the use of NE/NG tubes?
Feedings- liquid diets only!
How long are NE/NG tubes kept in place?
normally less than 5d, used for short term feeding only.
Contraindications for NE/NG tubes?
V+ or no gag reflex.
Where do you measure for the NG tube and why?
Tip of nose to 13th rib- ensure you are within the lumen of the stomach
Where do you measure for NE tubes and why?
Tip of nose to 8th/9th rib- ensure you're in distal esophagus
What type of sedation is normally needed for NE/NG tube placement?
What are pharyngostomy tubes usually indicated for?
Anorexic patients and those with facial trauma.
What are some contraindications for pharyngostomy tubes?
non-fx GI tract
Where does the pharyngostomy tube enter the esophagus?
through small incision on the right side of the neck behind the mandible to the distal esophagus
Where do you measure for pharyngostomy tubes?
from the angle of the mandible to the distal esophagus
What type of suture pattern is used to hold most tubes in place?
Chinese finger trap
When tube feeding, what is an indication of over feeding?
V+-sign of over extending the stomach
Which tube is better tolerated by the patient, pharyngostomy or esophagostomy tube?
Esophagostomy because less laryngeal irritation/obstruction; less likely to dislodge and less likely to induce emesis.
What is a contraindication of esophagostomy tube?
non-fx GI tract
Where would you measure for an esophagostomy tube?
mid-cervical esophagus to 7th rib
What does the PEG in PEG tube stand for?
Percutaneous Endoscopic Gastrotomy
Where does a PEG tube sit within the patient's abdomen?
After placement of a PEG tube, when can you begin to use it, and why?
Wait 72 hrs before, seal needs to form.
What are major concerns with the use of PEG tubes? DPHSDU