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Lesson 26. Types of Tubes

1-26. TYPES OF TUBES

There are many different tubes with different names for different purposes. The tube required for a specific treatment is ordered by the doctor. Since gastrointestinal tubes are inserted into nonsterile body cavities, sterile technique is usually not required for insertion, although the tubes are sterilized before use. The nursing paraprofessional should be familiar with the general characteristics and uses of each; the different types are usually ordered by name; for example:

a. Levin Tube. The Levin tube is flexible with soft walls, and is about four feet long. It is available in sizes 12 French (small) to 18 French (large). It has a rounded tip with multiple holes and is marked by single circular rings at 10cm. (4 inch) intervals, the first being 45cm. (18 inches) from the tip. The Levin tube is used primarily for long-continued gastric drainage and for gavage feeding. It is also used for diagnostic purposes. Its advantages are that it can be inserted either nasally or orally and that it is firm enough to be passed into an unconscious patient, but flexible enough so there is little danger of producing injury. The chief danger in passing this tube is the possibility of it entering the trachea rather than the esophagus. Care must also be taken to avoid injury to the mucous membrane.

b. Gastric Sump Tube. The gastric sump tube (salem, ventrol) is a flexible, double lumen tube. It is routinely used for continuous suction. One lumen is used for aspiration and irrigation. The smaller lumen provides a "vent" to the atmosphere. The advantage of this tube is the presence of the venting lumen, which decreases the occurrence of the tube obstruction.

c. Stomach Tube (Ewald). The stomach tube is a large caliber, heavy-walled, fairly stiff tube with a rounded tip and several large holes at one end. A funnel is attached to the other end to facilitate introducing large amounts of fluid into the stomach. It is used only for washing out the stomach (lavage). It is stiff enough to be readily inserted through the mouth into an unconscious or poorly cooperative patient or one with a hypersensitive gag reflex. The chief danger lies in its stiffness, which makes it capable of doing severe damage to the larynx or perforating the esophagus or stomach during insertion; therefore, the procedure should be done only under direct medical supervision.

d. Miller-Abbott Tube. The Miller-Abbott tube is a 10-foot long double lumen tube that is equipped with a small balloon near the metal tip at the distal end of the tube. One lumen is used for aspiration and irrigation; the other is used for inflating the balloon. Air, water, or mercury (4 to 5 ml) accomplishes inflation. This intestinal tube is used for small bowel suction. The two openings are independent of each other and are clearly marked. Preferably, this tube is inserted nasally; however, it can be used orally. Position of the tube is determined by aspiration first. X-ray may be used to determine the position in the small intestine. Peristaltic action carries the balloon and the tube through the intestine. When the first mark on the tube is at the patient's nose, suction is started. The doctor inflates the balloon after the tube has passed through the pylorus.

e. Cantor Tube. This is a 10-foot long, single-lumen tube used for intestinal decompression. The Cantor tube has a mercury-weighted rubber tab attached to its perforated tip to help carry the tube through the stomach and intestine. The mercury is placed in the bag with a syringe and needle before the tube is inserted nasally by the doctor.

f. Sengstaken-Blakemore Tube. Also referred to as a Blakemore tube, this tube is a three lumen, esophageal-gastric balloon tube that is used in the treatment of bleeding esophageal varices. One lumen is used to inflate the esophageal balloon, one lumen is used to inflate the gastric balloon, and the third lumen is used for decompression and irrigation of the stomach.

David L. Heiserman, Editor
Publisher: SweetHaven Publishing Services

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