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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
So, I had an email from a reader who says, “Is it normal that a nasogastric tube gets blocked in ICU on a on a regular basis?”
This is a reader who had their dad in ICU, for a few weeks in ICU, and he said that the nasogastric tube got blocked quite frequently. He said he went for long periods of times without feeds, potentially being malnourished because of that.
Now, it is definitely not common that a nasogastric tube gets blocked. So, nasogastric tube in ICU is usually used for enteral feeding, for nasogastric tube feeds so that nutrition can be maintained while a patient is either in an induced coma, on a ventilator, or even if they’re not ventilated but they can’t eat for whatever reason, that they can have nutrition, and meet their nutritional needs.
Now, when a nasogastric tube blocks, it is usually a sign that the medications that are given through the nasogastric tube are not crushed properly and that they’re not properly mixed in water. When you mix them in water, you got to make sure all their powder has gone. It’s got to be in that water so that it’s almost like water going through the nasogastric tube so that it doesn’t block. What is also important, that either after the enteral feeds are finished or after medications have been given, there always needs to be a generous water flush so that any substance that’s left in the nasogastric tube is flushed through because if you don’t do that, that’s when nasogastric tubes and also PEG (Percutaneous Endoscopic Gastrostomy) tubes for that matter, that’s when they block. None of them should block on a regular basis, whatsoever.
Now, if they do block and they can’t be unblocked for whatever reason, they need to be changed as a matter of urgency because nutrition and medications need to be given regardless. Sometimes medications can be given intravenously. That’s also the case with nutrition, that can also be given intravenously. It can be given via the central line or a PICC (Peripherally Inserted Central Catheter) line, and that’s called TPN, also known as total parenteral nutrition or intravenous nutrition, so there’s definitely solutions there.
But if the nasogastric tube blocks frequently, here’s another tip. So, there’s two types of nasogastric tubes. One is a wide-bore tube who’s reasonably big in diameter, and then there’s a fine-bore tube who’s reasonably small in diameter. Usually the wide-bore tube is used for short-term nasogastric tube feeds, and the fine-bore tube is used for long-term enteral feeds. So, it is also more likely that a fine-bore tube is getting blocked because again they are much narrower in diameter, and extra care needs to be given to those tubes to keep them flushed and patent. But the same really is true for a wide-bore tube as well, they all need to be flushed frequently to keep them patent.
I hope that helps you understand if a nasogastric tube should block regularly, it definitely shouldn’t. Also, if a nasogastric tube blocks frequently, a PEG tube is not the answer. Because the PEG tube would just block as easily if you’re not doing the right things, i.e. if you’re not crushing the tablets correctly, if you’re not flushing the PEG tube or the nasogastric tube through it all comes through. It all comes down to proper maintenance and care of the nasogastric tube.
Now I have worked in critical care for nearly 25 years as a nurse, and I have also worked as a nurse manager in critical care for nearly 5 years or for over 5 years, I should say. I’ve been consulting and advocating for families in intensive care here at intensivecarehotline.com since 2013. We have saved many lives as part of our consulting and advocacy for our clients in intensive care. You can verify that when you go to intensivecarehotline.com and you check out our testimonials there. Go to our testimonial section or you go to intensivecarehotline.com and you check out our podcast section and listen to some client interviews.
Because we get so many questions from families in intensive care every day all around the world, that’s why we also created a membership for families of critically ill patients in intensive care. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email, and we answer all questions intensive care related. In the membership, you also have access to 21 eBooks and 21 videos that I have personally written and recorded, and the access to me and my team, and the eBooks and the video will help you to make informed decisions, have peace of mind, control, power, and influence making sure your loved one gets best care and treatment while they are in intensive care.
I also do one-on-one consulting and advocacy over the phone, Zoom, Skype, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I also talk to doctors and nurses directly. I handhold you through the process when you have a loved one critically ill in intensive care because it’s a once in a lifetime situation that you can’t really afford to get wrong. When I talk to you directly, I make sure you make informed decisions, you have peace of mind, control, power, and influence, once again making sure your loved one gets best care and treatment while they have a loved one in intensive care. When I talk to doctors and nurses directly on your behalf or with you, I ask all the questions you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care.
I also represent you in family meetings with intensive care teams.
We also do medical record reviews in real time so that you can get a second opinion in real time. We also do medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are suspecting medical negligence.
All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or send us an email to [email protected] with your questions.
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I’ve got so many emails sitting from the last six months; I’m barely keeping up with all the questions that we’re getting.
Thank you so much for watching.
This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.
Take care for now.