PEG Tube to suction..

I need some advice. I recently had a patient with an ileus. The patient was extremely confused and had a peg tube. When I informed to doctor of the KUB results, he ordered and NGT. Another nurse on the unit said you can use the PEG tube for suction. I personally did not feel comfortable obtaining the order so the other nurse did. I consulted and ER nurse and an internal medicine MD for advice. Both advised me the above was not reccommended. I feel that the bowel and gastric mucosa can become damanged and/or damage the peg. I need some advice! Please help!
I have not been a nurse for a long, long time, but the years I have been a med/surg nurse, I have never had an order for a PEG to suction, and I have had a good many PEG tube patients. NGT or Dobhoff-yes. And, a lot of the time it was only to intermittent suction. I had a surgeon explain to me that he preferred low intermittent suction because stuff can stick to the suction tubing, and the suction stopping for a bit lets it get lose, and then it gets suctioned on out. Also, easier on stomach mucosa. Anyway, I am sure there are many other nurses, ICU nurse experts, and nurses with more experience that have better advice. This is just my experience thus far.

I personally have seen PEG tubes to suction...but few and far between. It's not something that's done on a regular basis. At the end of the day, you have to follow the MD's orders. If you don't feel comfortable, ask the GI doc on the case unless it was GI who ordered it....more than likely the attending doc isn't going to go against GI. And sticking a NGT or Dobhoff in can damage the mucosa...it's a foreign body...follow the orders. If there's an order, then your butt is covered. You can also politely ask the doc the rationale behind suctioning through the PEG vs. a NGT.

I've had PEG tubes ordered to gravity drainage, but never to suction.

I work in peds and we only put the GTs to gravity, never to suction, for exactly the reason you stated.

I've seen a Peg tube attached to low wall intermittent suction before. The patient had something perfed, and bowell contents were just pouring out of his wounds. The peg to suction was a last-ditch effort in order to controll the leaks. The patient also had a Moss tube as well. I suppose they use it in severe cases only. I've only seen it once though.

Quote from himilayaneyes At the end of the day, you have to follow the MD's orders. ...follow the orders. If there's an order, then your butt is covered.

How did they get a diagnosis from a Kidneys, Ureters and Bladder X ray and not a AXR?Also never seen a peg to suction. Gravity yes with orders for in the bed or hanging lower on the cot sides. With or without 4 hourly aspirates.

Quote from himilayaneyesI personally have seen PEG tubes to suction...but few and far between. It's not something that's done on a regular basis. At the end of the day, you have to follow the MD's orders. If you don't feel comfortable, ask the GI doc on the case unless it was GI who ordered it....more than likely the attending doc isn't going to go against GI. And sticking a NGT or Dobhoff in can damage the mucosa...it's a foreign body...follow the orders. If there's an order, then your butt is covered. You can also politely ask the doc the rationale behind suctioning through the PEG vs. a NGT.

Quote from jess1983_lpni've seen a peg tube attached to low wall intermittent suction before. the patient had something perfed, and bowell contents were just pouring out of his wounds. the peg to suction was a last-ditch effort in order to controll the leaks. the patient also had a moss tube as well. i suppose they use it in severe cases only. i've only seen it once though.

I work in hospice, so it is a little different, but we often have peg tubes placed specifically for stomach draining r/t obstruction (usually from CA). We usually use suction, but usually intermittently. I have not seen any issues with this, and it is certainly kinder than a long term ng tube. Again, i realize that this is a different situation.

I've seen PEG to suction ordered on rare occasions, usually in patients with extensive abdominal trauma.

Quote from KarenmaireHow did they get a diagnosis from a Kidneys, Ureters and Bladder X ray and not a AXR?