16: Tubes and drains Flashcards
How much of the GI tract should you try to use?
As much as possible
How often should you weight the patient?
Daily
Which species usually gets an NG tube?
Cats
What are disadvantages of NG tube?
Small diameter, can only have for one week
How do you verify NG tube placement?
Vacuum, well tolerated water injection
How often should you re-check NG placement?
Before every feed
How do you secure an NG tube?
Glue, staples, suture
What are three advantages of oesophagostomy tube?
Better for long term home care, won’t cause peritonitis, patients can eat around it
What are two disadvantages of oesophagostomy tube?
Can’t use if vomiting, requires GA, food can leak into peri-oesophageal tissues
What must you avoid when placing an oesophagostomy tube?
Jugular
How do you check oesophagostomy tube placement?
Radiograph
How do you secure an oesophagostomy tube?
Fingertrap
How do you bandage an oesophagostomy tube?
Loosely, not vetrap
What is the advantage of a gastrostomy tube?
Long-term feeding at home
What is the indication for a gastrostomy tube?
During abdominal surgery, if there is oesophageal disease
What are the disadvantages of a gastrostomy tube?
Risk of peritonitis, can’t remove before 7-10 days
Which part of the stomach do you place an gastrostomy tube?
Closest to the skin
What are the uses of a thoracostomy tube?
Remove fluid or air or deliver anaesthesia
What are the three types of thoracostomy tube?
Trochar, non-trochar or Seldinger types
WHich type of thoracostomy tube needs a GA?
Trochar
How many rib spaces forward do you go in a trochar placement?
2-4
What equipment do you need for trochar placement?
Clamps, 3 way tap, cone, vest, observation
What are the advantages of Seldinger types?
More comfortable, only need local and light sedation, more secure
Which effusions can you use seldinger for?
All
When do you remove a chest drain?
When air is negligible and fluid is below 2-4ml/kg/day
Where should a drain always exit?
Separately from the wound
When do you remove a Penrose drain?
When fluid reduces or after 3-5 days
When should you use active suction?
If oncological, infected, to prevent seroma
When do you turn on an active suction drain?
6-8 hours after placement once fibrin seal has formed
When do you remove an active suction drain?
WHen production below 2-4ml/kg/day
What is an advantage of active suction?
Less ascending infection
