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1134.e6 Nasal Flush

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A B

C D

NASAL FLUSH A, This skull demonstrates that the distal end of the red rubber tube with attached suture is retrieved
from the pharynx using a spay hook. The suture and catheter end are pulled into the mouth to allow attachment to
the second red rubber tube. B, The second red rubber tube is attached to the first, leaving a length of suture between
the ends of the two. C, The red rubber tube protruding from the nose can be used to pull the second red rubber tube
into the mouth through the pharynx and into the nasal passages. D, In actual use, a large syringe of saline would be
attached to the catheter tip of the second red rubber tube (protruding from the mouth). After the second red rubber
tube is pulled into the caudal nasal passage, the syringe would be emptied while the first red rubber tube (now outside
the nose) is used to pull the second red rubber tube forward. After pulling, the end of the second red rubber tube
with long attached suture ends would exit the nostril. The long suture ends and flushing action often dislodge foreign
material from the nose.

the nasopharynx; if there is a lot of resistance, • Cut the end off of the second red rubber • Dampen the lap sponge,and gently insert it
back up and start again. tube as for the first, and again pierce near into the oropharynx to protect the airway. The
• Continue advancing the tube until the the cut end with the 20-gauge needle. author puts a piece of white medical tape on
cut end (and suture) is well within the • Thread the long end of the suture already the patient’s forehead as a reminder to remove
pharynx. tied to the first red rubber tube through the the lap sponges at the time of extubation.
• Open the patient’s mouth, and gently sweep second red rubber tube using the needle as Check that the endotracheal cuff is inflated.
the oropharynx with the spay hook. a guide. Remove the needle, and tie suture • Using the first red rubber tube, gently pull
• Once caught, gently pull the tube and the on the second red rubber tube in the same the second red rubber feeding tube through
suture out of the patient’s mouth (either end way as for the first. There should be about the mouth and over the soft palate.
of the same tube is now protruding from the 1 inch (2.5 cm) of suture between the two • Let the patient’s head hang off the end of
nose and the mouth). cut ends of the red rubber tubes. the table.

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