INSERTION OF SENGSTAKEN-BLAKEMORE (SB) TUBE BALLOON TAMPONADE

INSERTION OF SENGSTAKEN-BLAKEMORE (SB) TUBE BALLOON TAMPONADE – Definition, Purpose, Equipment, Procedure and Post-Procedural Care

DEFINITION

Exerting pressure directly on bleeding sites in esophagus and stomach by using SB tube

PURPOSE

To arrest acute bleeding from esophageal varices and stomach

EQUIPMENT

  • Sengstaken-Blakemore tube
  • Curved artery forceps to be protected with rubber tubing, lubricant adhesive, tincture, benzoin, syringes, gloves, Vaseline gauze

PROCEDURE

  • Explain procedure to patient and relatives
  • Place the patient in supine position
  • Pass SB tube through nose into stomach with balloons deflated
  • After tube reaches stomach inflate gastric balloon with 100-300 ml of air and clamp lumen
  • Pull out tube gently till balloon is held tightly against cardioesophageal junction
  • Secure tube to face with adhesive after placing gauze around nostril
  • Check for further hematemesis
  • Inflate esophageal balloon (20-45 ml of air) and clamp
  • Aspirate all blood from stomach, since blood products breakdown into ammonia which may precipitate hepatic coma
  • Document time, procedure and amount of blood aspirated

POST-PROCEDURAL CARE

  • Be aware of pressure exerted by inflated balloons
  • Monitor vital signs every 15 minutes
  • Reassure patient and relative
  • As soon as bleeding has been controlled, transfuse whole blood to prevent hypovolemic shock
  • Provide frequent mouth care
  • Clean nostrils and lubricate
  • Encourage passive exercises
  • Administer antibiotics
  • If gastric balloon ruptures, esophageal balloon is deflated at once and entire tube is removed
  • Look for complications like rupture, erosion of esophagus, occlusion of airway by balloon and aspiration of secretions
  • Document level of consciousness, time, whether gastric/esophageal balloon is inflated, amount of gastric aspiration and irrigation and vital signs
INSERTION OF SENGSTAKEN-BLAKEMORE (SB) TUBE BALLOON TAMPONADE – Definition, Purpose, Equipment, Procedure and Post-Procedural Care
INSERTION OF SENGSTAKEN-BLAKEMORE (SB) TUBE BALLOON TAMPONADE – Definition, Purpose, Equipment, Procedure and Post-Procedural Care

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