b. The Miller-Abbott (or Cantor) tube is not taped to the patient's face following
intubation. Since the tube is designed to advance through the stomach into the small
intestine by gravity and peristalsis, taping or otherwise securing the outside length could
interfere with the desired advancement. The long, distal length of tube is coiled loosely
at the head of the bed unless otherwise ordered.
c. Position and activity of the patient following intubation contribute to the
advancement rate of the tube. The nursing staff must know the position, the sequence,
and the time interval ordered for each change in position, and modify other patient care
measures accordingly. For example, after the tube has been introduced into the
stomach, placing the patient on his right side with the foot of the bed elevated for a
specified time interval facilitates the passage of the tip of the tube into the pylorus.
Once the tube starts to advance, subsequent positions may be ordered: on the back, in
Fowler's position; and finally, left lateral recumbent, with the bed flat; followed by
Explaining to the patient and securing his full cooperation is very important,
but the patient may be too ill to understand instructions or to realize that the
tube is anything more than a constant source of annoyance and discomfort.
1-34. CARE AND HANDLING OF DRAINAGE DURING TREATMENT
a. Observe frequently the color and amount of drainage. Report any changes
immediately to the professional nurse. Cloudy, pale-yellowish drainage is characteristic
when the tube is in the stomach; bile-colored (greenish) drainage is characteristic when
the tube is in the duodenum. In gastrointestinal drainage, blood varies in color--it may
be dark red when fresh, dark brownish-red or in brown particles ("coffee ground
drainage") if it has been partially digested. Fecal odor of the drainage is noticeable in
intestinal obstruction. Note your observations in the patient's nurse's notes.
b. Measure the contents and empty the drainage bottle at the hours ordered by
the physician, when the drainage bottle is two-thirds full or when suction is discontinued.
c. Procedure for emptying the drainage bottle.
(1) Clamp the nasogastric tube. Remove stopper of drainage bottle. Place
stopper in emesis basin. Take bottle to utility room.
(2) Measure and record amount of drainage. Dispose of measured
drainage by flushing into hopper or toilet.
(3) Rinse the bottle with cold water. Wash thoroughly with prescribed
detergent solution. Rinse and drain.
(4) Reconnect clean bottle, replacing the stopper securely. Release clamp.
Observe for effective renewal of suction drainage.