• Coagulopathy (prothrombin time > 18 seconds).
• Thrombocytopenia (platelet count < 100,000/mcL).
• Recent intestinal tract surgery (< 1 month ago).
• Lubricant gel.
• Large bore orogastric tube.
• Terumo 60-mL catheter tip syringe.
• Normal saline at 38 °C.
• Drainage basin.
• Measure length of tube insertion by positioning
the tube from the nares or mouth to the ear, and to the umbilicus.
• There is also a standard table, which uses height of child.
• If the tube is obstructed, flush first with water; longstanding
obstruction may be removed by flushing the tube with caffeinated
• Lubricate tube with gel.
• Insert the tube through the mouth midline after lubrication.
• Ask the patient to cooperate by swallowing while the tube is
• Advance the tube to the length mark.
• To check position, aspirate tube with 50-mL catheter tip syringe
(Figure 26–2); gastric aspirate
confirms positioning in stomach.
• Insert small amount of air (20–30 mL)
via orogastric tube while listening to the epigastric area with
• If unsure about tube position, obtain a chest film to confirm
• Secure tube to the face with tape.
• After insertion of the orogastric tube, begin to irrigate stomach
• Use 10–15-mL/kg aliquots of warm (38 °C) isotonic saline.
• Lavage should continue until the effluent is clear.
• For diagnostic lavage, notice presence of fresh red blood, blood
clots, or coffee ground material to confirm upper gastrointestinal
• At this time, diagnostic lavage should be stopped.
• Confirm presence of blood with Gastroccult cards.
Measuring the length of tube for insertion.
Checking the position of the tube.
• Mucosal tears.
Log In to View More
If you don't have a subscription, please view our individual subscription options below to find out how you can gain access to this content.
Want remote access to your institution's subscription?
Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.
If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.
AccessPediatrics Full Site: One-Year Subscription
Connect to the full suite of AccessPediatrics content and resources including 20+ textbooks such as Rudolph’s Pediatrics and The Pediatric Practice series, high-quality procedural videos, images, and animations, interactive board review, an integrated pediatric drug database, and more.
Pay Per View: Timed Access to all of AccessPediatrics
24 Hour Subscription $34.95
48 Hour Subscription $54.95
Pop-up div Successfully Displayed
This div only appears when the trigger link is hovered over.
Otherwise it is hidden from view.