TUBES

Nasogastric tube most often used ia Levine tube

Ryles tube

Identification points

·      The tube used most often has blunt end with multiple opening near the lower end which is closed.

·      The Ryles tube has a metal ball around which the tube is moulded. 

     This acts as weight for introducing the tube.

     The tube is made rubber (so that it becomes flexible) and also of transparent protex (because it may cause less irritation).

Marking of Ryles tube

The tube has four marks: mark 1when the tip enters the stomach (40 cm);
second mark 2 when the tip arches antrum (50cm);
mark 3 at 57 cm,  when it indicates the entry into the pylorus;
and mark 4 (at 65cm) indicates entry into the duodenum.

How is Ryles tube introduced?

The patient is asked to sit up. 

The tip is placed in the nose and fed in till it reaches pharynx and the patient is asked to swallow

till the tube reaches the desired mark.

Uses

·      Ryles tube is used to aspirate stomach juices in postoperative period.

·      It is also used to aspirate in cases of acute abdomen–intestinal obstruction, perforation, appendicular mass, acute cholecystitis and strangulated hernia.

·      It is also used in gastric acid-secretion tests.

·      Ryles tube is used in gastric feeding of unconscious patient.

·      It is used to perform gastric lavage.

·      It is also used to confirm the diagnosis of pernicious anaemia.

Stomach tube

Identification points

·      It is wide-bore rubber tube. 

    The tube end is rounded to allow introduction in the body without injury, the upper end has a funnel to allow pouring of lavage fluid.

·      Wash out occurs when this end is lower than the patient.

Uses

Stomach tube is used in the management of alcohol poisoning,

organophosphorus compound poisoning,

barbiturate poisoning and

opium or morphine poisoning.

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