NG tube

[GilWest]

Anyone else have to have an ng tube before placement of a peg? Doc said he was not satisfied with mom's blood chemistry and would like her to be a little more nourished before surgery.

 

[zoohouse]

When they are putting a PEG tube in under fluoroscopy they have to insert an NG tube so that they can inflate the stomach. They do this for a couple of reasons. It makes the stomach larger and easier to feel and closer to the abdominal wall, and also helps prevent pushing the trochar through the other side of the stomach when they insert it. A trochar is like a sharp knitting needle that goes through the PEG tube that can perforate through the skin, abdominal wall and the stomach wall pushing bowel out of the way. When they feel the pop of going into the inflated stomach and here a rush of air they know they are in the correct place. The trochar is pulled out of the PEG tube, leaving it flexible and patent. After that the NG tube is pulled out and liquids can be put through in 24 hours. In Tim's case the NG was just put in prior to the procedure, but it sounds like they want to put one in to feed your mother through for a while. NG tubes are not painful, but can be very irritating. Tim said it was the worst part of the procedure, but they use to insert NG tubes in me in nurses training for practice, and I didn't find it bad at all. When I put an NG tube in I always ask if the person has a deviated septum, and check to see which nostril is most open. I also use "Hurricane spray" which is liquid xylocaine that I spray up into the sinus so that it isn't so comfortable. Not all nurses a versed in this technique.
Paulette

 

[GilWest]

Mom is having a time with it. She really cannot cough and gag that well and it is increasing her secretions. I spent the first 1/2 suctioning excess saliva. She said it felt like she said (wrote) it felt like she had swallowed a necklace.

 

[MaxEidswick]

>She said it felt like she said (wrote) it felt like she had swallowed a necklace

I can relate -- for me it is like a hot tiny tennis ball .. will try to sleep now ,,,,

 

[GilWest]

When they are putting a PEG tube in under fluoroscopy they have to insert an NG tube so that they can inflate the stomach. They do this for a couple of reasons. It makes the stomach larger and easier to feel and closer to the abdominal wall, and also helps prevent pushing the trochar through the other side of the stomach when they insert it. A trochar is like a sharp knitting needle that goes through the PEG tube that can perforate through the skin, abdominal wall and the stomach wall pushing bowel out of the way. When they feel the pop of going into the inflated stomach and here a rush of air they know they are in the correct place. The trochar is pulled out of the PEG tube, leaving it flexible and patent. After that the NG tube is pulled out and liquids can be put through in 24 hours. In Tim's case the NG was just put in prior to the procedure, but it sounds like they want to put one in to feed your mother through for a while. NG tubes are not painful, but can be very irritating. Tim said it was the worst part of the procedure, but they use to insert NG tubes in me in nurses training for practice, and I didn't find it bad at all. When I put an NG tube in I always ask if the person has a deviated septum, and check to see which nostril is most open. I also use "Hurricane spray" which is liquid xylocaine that I spray up into the sinus so that it isn't so comfortable. Not all nurses a versed in this technique.
Paulette

They were Leary about putting any liquids in her nose or throat for fear of aspiration.

 

[zoohouse]

Well they will probably insert the PEG using that NG, once her nutrition is where it needs to be. I have been racking my brain trying to think of something that might make the NG more comfortable, but anything I can think of would not be safe with someone with ALS. I use to have my patients gargle a special mouthwash that has lidocaine in it and then spit it out, not practical for someone who can neither gargle or spit. I just pray that the feeds build her up quickly so she can get the PEG placed and go home.

Paulette