Intestinal decompression accomplished by intubation and application of suction is similar in many respects to gastrointestinal suction drainage with a nasogastric tube.

Important differences include the following considerations:

a. Intubation is done by the medical officer.

b. The Miller-Abbott (or Cantor) tube is not taped to the patient’s face following intubation. Since the tube is designed to advance through the stomach into the small intestine by gravity and peristalsis, taping or otherwise securing the outside length could interfere with the desired advancement. The long, distal length of tube is coiled loosely at the head of the bed unless otherwise ordered.

c. Position and activity of the patient following intubation contribute to the advancement rate of the tube. The nursing staff must know the position, the sequence, and the time interval ordered for each change in position, and modify other patient care measures accordingly. For example, after the tube has been introduced into the stomach, placing the patient on his right side with the foot of the bed elevated for a specified time interval facilitates the passage of the tip of the tube into the pylorus. Once the tube starts to advance, subsequent positions may be ordered: on the back, in Fowler’s position; and finally, left lateral recumbent, with the bed flat; followed by ambulation.

NOTE: Explaining to the patient and securing his full cooperation is very important, but the patient may be too ill to understand instructions or to realize that the tube is anything more than a constant source of annoyance and discomfort.