My question is in relation to the clinical practice of having an orogastric or nasogastric tube hooked up to intermittent suction while the patient is being fed with a Keofeed tube (Kendall Medical) that is in the duodenum. Is this a proper practice? Is it not safe or is it incorrect to have an orogastric or nasogastric tube hooked up to intermittent or continuous suction to pull out bilious gastric fluid while the patient is being fed postpylorically with a Keofeed tube?

Jan M. Powers, rn, phd, ccrn, ccns, cnrn, replies:

This is a great question. Practices may vary depending on the accepted standards at each institution. The practice of gastric tube placement when feeding via the small bowel (duodenum or jejunum) should be individualized on the basis of the patient’s condition and needs.

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