How Can INTENSIVE CARE AT HOME Change Nasogastric Tubes at Home?

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How Can INTENSIVE CARE AT HOME Change Nasogastric Tubes at Home?

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Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies at home and where we also provide tailor-made solutions for hospitals and intensive care units at home whilst providing quality care for long-term ventilated adults and children with tracheostomies at home, otherwise medically complex clients, adults and children at home, which includes Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure), home tracheostomy care for adults and children that are not ventilated, Home TPN (Total Parenteral Nutrition, home IV potassium infusions, home IV magnesium infusions, and home IV antibiotics. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management as well as Hickman’s line management, and we also provide palliative care services at home.

We’re also sending our critical care nurses into the home for emergency department bypass services as we have done so in the past successfully for the Western Sydney Local Area Health District for their in-touch program.

In my last blog, I was talking about, “Can Intensive Care at Home look after nasogastric tubes at home?” I actually talked about the case study from one of our previous clients.

Now, one thing that I actually forgot to mention in that blog was how do we actually change nasogastric tubes at home. That’s what I want to focus on today, because it’s one skill to look after nasogastric tubes at home, which we obviously have because all of our staff are critical care nurses with a minimum of two years critical care nursing experience. Most of them have done a postgraduate critical care qualification, similar to an intensive care unit, which keeps our quality standards extremely high.

Nasogastric tube is part of our skill set, of course. But the question is, how do we actually change them at home? Because a nasogastric tube needs to be changed in sort of a 3 to 6 monthly interval or, God forbid, a client might also pull out the nasogastric tube or a nasogastric tube might get blocked every so often and then the nasogastric tube needs to be changed. So obviously, it is within the skill and scope of practice of a critical care nurse to change a nasogastric tube.

So, once it’s been changed, the position needs to be confirmed, making sure it’s actually in the stomach and not in the lungs, God forbid. So, you can check the position by using a stethoscope and a bladder syringe and inject some air and you hear a bubble. You need to know what you’re doing; you need to have done a competency for that, or you check the pH of the nasogastric tube. Basically, aspirate from the nasogastric tube and you check the pH making sure it’s within a certain range which also indicates that it’s in the stomach.

However, those two tests are not enough by itself. It also needs to be followed up by a chest X-ray to confirm the position. So, you might think, “Oh, Patrik, how can that be done at home?” Well, it can be done at home and a big shout out to Mobile Radiology in Melbourne, but they’re now also in Sydney, Brisbane, and Adelaide. They have helped us with home x-ray. So, big shout out to Michael Montalto and his team from Mobile Radiology in Melbourne that are doing the home X-rays. It’s a fantastic service and it is so well aligned with what we are doing, which is keeping our clients at home predictably.

Continue reading at: https://intensivecareathome.com/how-can-intensive-care-at-home-change-nasogastric-tubes-at-home/