What is a Salem Sump Tube?
A
Salem sump tube is a double-lumen nasogastric tube primarily used for gastric decompression. It is named after the Salem Hospital in Massachusetts, where it was first developed. The Salem sump tube has two lumens: a large lumen for suction and drainage and a smaller lumen, known as the "pigtail," which acts as an air vent to prevent the tube from adhering to the stomach lining.
Indications for Use
The Salem sump tube is commonly used in various clinical scenarios, including: Gastric decompression in patients with bowel obstruction, ileus, or trauma.
Removal of gastric contents to prevent aspiration in patients who are intubated or have compromised airway reflexes.
Administration of medications and enteral nutrition when other routes are not feasible.
Diagnostic purposes, such as sampling gastric contents.
Insertion Procedure
Explain the procedure to the patient, ensuring they understand the purpose and process.
Gather necessary supplies: gloves, lubricant, Salem sump tube, water or saline, and a syringe.
Position the patient in a high Fowler's position to facilitate insertion and reduce risk of aspiration.
Measure the length of the tube from the tip of the nose to the earlobe and then to the xiphoid process, marking the tube appropriately.
Lubricate the tip of the tube and insert it gently through the nostril, directing it posteriorly.
Advance the tube while encouraging the patient to swallow, which helps guide it into the esophagus and then the stomach.
Verify correct placement by aspirating gastric contents and checking pH, or via X-ray if necessary.
Secure the tube to the patient’s nose and connect it to the appropriate suction device or feeding apparatus.
Care and Maintenance
Proper care and maintenance of the Salem sump tube are crucial to prevent complications such as infection, blockage, or accidental dislodgement. Regularly check the placement and patency of the tube by aspirating gastric contents and monitoring for any signs of blockage or displacement.
Flush the tube with water or saline to maintain patency, especially before and after medication administration or feeding.
Inspect the skin around the insertion site for signs of irritation or infection and provide appropriate skin care.
Ensure that the air vent (pigtail) remains open and above the level of the stomach to prevent the tube from adhering to the gastric mucosa.
Complications
While the Salem sump tube is generally safe, certain complications can arise, including: Nasal irritation or ulceration due to prolonged tube placement.
Aspiration of gastric contents if the tube becomes dislodged or malfunctions.
Infection at the insertion site or within the gastrointestinal tract.
Blockage or kinking of the tube, leading to ineffective decompression or feeding.
Patient discomfort or anxiety related to the presence of the tube.
Patient Education
Educating patients and their families about the purpose and care of the Salem sump tube is essential for successful management. Explain the reasons for tube placement and how it helps manage their condition.
Teach them how to recognize signs of complications, such as increased pain, swelling, or difficulty breathing.
Provide instructions on maintaining tube patency, including regular flushing and proper positioning of the air vent.
Encourage them to report any concerns or discomfort to the healthcare team promptly.
Conclusion
The Salem sump tube is a valuable tool in nursing care for patients requiring gastric decompression or enteral feeding. Proper insertion, maintenance, and patient education are critical to ensuring its efficacy and minimizing potential complications. By understanding the indications, procedure, and care involved, nurses can effectively manage patients with a Salem sump tube and contribute to their overall recovery and well-being.
