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
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