Podcast 721: Blakemore & Minnesota Tubes: Part II

<p><strong>Contributor: Dylan Luyten, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">To place a Blakemore/Minnesota Tube:</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Insert into esophagus under visualization</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Inflate gastric port with 60 cc of air and obtain a chest xray to ensure the balloon below the diaphragm</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Once confirmed, place a total of 500cc of air into the gastric balloon via the gastric port</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Tie a liter saline bad to the tube using Kerlix and hang it off an IV pole or other object to provide about 2 lbs of traction</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Now the the tube is in place under traction, attach a manometer to the esophageal balloon port</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Provide low pressure to tamponade a variceal bleed, which is about 33 mmHg</span></li> </ul> </li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">This is a temporizing measure and often patients need to get a Transjugular Intrahepatic Portosystemic Shunt (TIPS) from interventional radiology for more definitive treatment</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Powell M, Journey JD. Sengstaken-Blakemore Tube. [Updated 2021 Jul 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558924/</span></p> <p><span style="font-weight: 400;">Amazing video of placement by EM:RAP Productions</span><a href= "https://w