GASTRIC SUCTION TUBE IRRIGATION

PURPOSE
The purpose of this practice support document is to provide the clinician guidance on care of the patient with a
gastric tube.
POLICY STATEMENTS
When gastric tubes are being used for suction, it is important to ensure that they are patent and draining
effectively. To do this, it is recommended that the tubes be irrigated on a regular basis. Preventing tube
occlusions is a routine part of nursing practice.
Nasogastric tubes used for suction or drainage will be irrigated at least every 2 hours and when needed
(PRN) as per patient reports of abdominal discomfort, nausea or vomiting, leaking from tube, gastric distention
or gastric distress.
Per the CRNBC Scope of Practice for Registered Nurses, an RN may, for the purposes of assessment or
ameliorating or resolving a condition identified through the making of a nursing diagnosis, administer a solution
by irrigation without an order.
SITE APPLICABILITY
This guideline is applicable in all clinical areas within BCCH and SHHC.
PRACTICE LEVEL/COMPETENCIES
The assessment and management of gastric tubes is a foundational level competency for registered nurses
(RN) working in acute care areas at BCCH and SHHC.
EQUIPMENT
• syringe of appropriate size and tip
• normal saline or irrigating solution as ordered
• plastic backed absorbent pad
• B-D adaptor for syringe as necessary
• appropriate personal protective equipment (PPE)

PROCEDURE Rationale
1. GATHER equipment Facilitates completion of task in a timely manner.

2. IDENTIFY patient using 2 client identifiers and
EXPLAIN procedure. Consider distraction
techniques or accessing appropriate resources
to help child cope with procedure as needed.
Engage child life specialist as needed.
Failure to correctly identify patients prior to
procedures may result in errors.
Reduces child and family’s anxiety. Evaluates and
reinforces understanding of previously taught
information and confirms consent for procedure.

3. PERFORM hand hygiene and DON gloves and Standard/routine precautions; reduces risk of
other PPE as necessary. blood and body fluid exposure.

5. DISCONNECT tube from suction and attach Allows fluid to clear the tube.
saline-filled syringe to tube. Slowly and gently
instill fluid into the tube.
NOTE: Amounts of irrigating solution vary
according to tube sizing. Usual

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recommended amounts are:

• 1-3 mL in infants
• 3-10 mL in children
• 10-15 mL in adolescents

4. If solution does not instill easily,
a. ROTATE tube or move it slightly and
attempt to instill solution, or
b. PUSH and PULL the plunger of the
syringe and attempt to instill solution
Tube may be too close to stomach wall to allow
solution to flow.
Alternating pressure helps work out any
obstruction.

5. NOTIFY physician if solution cannot be instilled May require physician intervention.

without considerable force.

6. ASPIRATE fluid gently, noting appearance and Prevents adding extra fluid volume to the stomach
volume; DISCARD fluid. REPEAT irrigation and and ensures patency of tube.
aspiration if necessary.

7. RECONNECT tube to suction. Re-establishes therapy.

8. OBSERVE for drainage and adjust the suction To confirm that suction is functioning properly.
to pressure ordered by physician to reach the
desired level of suction.
NOTE: Bubbling or fluid movement should be
present in the tube during suction cycle.

9. REMOVE gloves/PPE and discard in Standard/routine precautions; reduces

appropriate container. PERFORM hand hygiene. transmission of microorganisms.

10. REPLACE irrigation syringe every 24 hours. Standard/routine precautions; reduces

transmission of microorganisms.

DOCUMENTATION
Document the following on the appropriate record(s):
• procedure and time
• patency of tubing
• amount and type of irrigating solution used
• amount and character of irrigated returns
• patient's response to procedure
• any other pertinent actions or observations
Document all care provided on the inpatient flowsheet and in the nurses notes.
Document on the Integrated Inpatient care plan as needed to reflect patient care needs.

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REFERENCES
Alfors, L, Boullier, P, Hicks, P, Jacobs, M, Lett, D, Sanford, J, Schachman, K, Smith, A, Tinson-Jenkins, B and
Wills, J. (2006). Chapter 7: Fluids and nutrition (pp. 346-456). In J. Smith-Temple & J.
Johnson’s Nurse’s Guide to Clinical Procedures. Philadelphia, PA: Lippincot, Williams & Wilkins.
College of Registered Nurses of British Columbia (2017). Scope of Practice for Registered Nurses: Standards
Limits Conditions. Publication Number 433. British Columbia: Author. Retrieved from:
https://www.crnbc.ca/downloads/433-scope.pdf
Lippincott. (2015) Lippincott’s Nursing Procedures. Philidelphia, PA. Lippincott Williams & Wilkins.
Mandleco, BL. (2005). Pediatric Nursing Skills and Procedures. New York: Thomson Delmar Learning.
Perry, S. E., Hockenberry, M. J., Lowdermilk, D. L., Wilson, D., Keenan-Lindsay, L., & Sams, C. A. (2013).
Maternal child nursing care in Canada. Toronto, ON: Elsevier Canada
Surratt, S, Bourquin Ryan, A, Hallenbeck, P, Blandon, MM, and Sugarbaker, PH. (1993). Troubleshooting a
Sump Tube. The American Journal of Nursing. 93(1):42-47.

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