Balloon tamponade for massive GI bleeding/es - Revision history

Jhattery: Created page with "Tubo de Sengstaken-Blakemore Tubo de Sengstaken-Blakemore https://www.youtube.com/watch?v=NHelCd5Jtp4 #Intubar al paciente #Inflar y desinflar completamente cada balón utilizando su respectivo puerto para verificar fugas #Si se utiliza el tubo de Sengstaken-Blakemore, asegure el tubo nasogástrico al dispositivo de tamponada con el extremo distal del tubo..."

2026-02-01T01:18:52Z

Created page with "thumb|Tubo de Sengstaken-Blakemore thumb|Tubo de Sengstaken-Blakemore https://www.youtube.com/watch?v=NHelCd5Jtp4 #Intubar al paciente #Inflar y desinflar completamente cada balón utilizando su respectivo puerto para verificar fugas #Si se utiliza el tubo de Sengstaken-Blakemore, asegure el tubo nasogástrico al dispositivo de tamponada con el extremo distal del tubo..."

← Revisión anterior		Revisión del 01:18 1 feb 2026
Línea 63:		Línea 63:


	~~<div lang="en" dir="ltr" class="mw-content-ltr">~~
	===Minnesota===		===Minnesota===
	~~</div>~~

	https://www.youtube.com/watch?v=4FHIiA_doWU		https://www.youtube.com/watch?v=4FHIiA_doWU

Jhattery: Created page with "Category:Procedimientos Category:AP category:Cuidados Críticos"

2026-02-01T01:17:34Z

Created page with "Category:Procedimientos Category:AP category:Cuidados Críticos"

← Revisión anterior		Revisión del 01:17 1 feb 2026
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	==Enlaces Externos==		==Enlaces Externos==

	*[http://lifeinthefastlane.com/ccc/senkstaken-blackmore-and-minnesota-tubes/ LITFL: Sengstaken-Blackmore ~~and~~ Minnesota ~~Tubes~~]		*[http://lifeinthefastlane.com/ccc/senkstaken-blackmore-and-minnesota-tubes/ LITFL: Tubo de Sengstaken-Blackmore y Minnesota]
	*[http://emcrit.org/procedures/blakemore-tube-placement/ EMCRIT: Blakemore ~~Tube Placement for Massive Upper GI Hemorrhage~~]		*[http://emcrit.org/procedures/blakemore-tube-placement/ EMCRIT: Colocación del Tubo de Blakemore para Hemorragia Masiva de la Parte Alta del Tracto Gastrointestinal]


	~~<div lang~~=~~"en" dir~~=~~"ltr" class~~=~~"mw-content-ltr">~~		==Referencias==
	=~~=References==~~
	~~</div>~~

	~~<div lang="en" dir="ltr" class="mw-content-ltr">~~
	<references/>		<references/>
	~~</div>~~

	~~<div lang="en" dir="ltr" class="mw-content-ltr">~~		[[Category:Procedimientos]]
	[[Category:~~Procedures~~]]		[[Category:AP]]
	[[Category:GI]]		[[category:Cuidados Críticos]]
	[[category:~~Critical Care~~]]
	~~</div>~~

Jhattery: Created page with "==Procedimiento=="

2026-02-01T01:17:05Z

Created page with "==Procedimiento=="

← Revisión anterior		Revisión del 01:17 1 feb 2026
Línea 89:		Línea 89:


	~~<div lang~~=~~"en" dir~~=~~"ltr" class~~=~~"mw-content-ltr">~~		==Complicaciones==
	=~~=Complications==~~
	~~</div>~~

	~~<div lang="en" dir="ltr" class="mw-content-ltr">~~		Debido a la colocación incorrecta del balón, migración, inflación excesiva, uso prolongado
	*Due to misplaced balloon, ~~migration~~, ~~over-inflation~~, ~~prolonged use~~		**Ulceração mucosal
	**~~Mucosal ulceration~~		**Aspiración
	**~~Aspiration~~		**Obstrucción de la vía aérea o de un vaso sanguíneo grande
	**~~Airway or large vessel obstruction~~		**Ruptura esofágica
	**~~Esophageal rupture~~
	~~</div>~~


	~~<div lang~~=~~"en" dir~~=~~"ltr" class~~=~~"mw-content-ltr">~~		==Ver También==
	=~~=See Also==~~
	~~</div>~~

	{{GI bleeding pages}}		{{GI bleeding pages}}


	~~<div lang~~=~~"en" dir~~=~~"ltr" class~~=~~"mw-content-ltr">~~		==Enlaces Externos==
	=~~=External Links==~~
	~~</div>~~

	~~<div lang="en" dir="ltr" class="mw-content-ltr">~~
	*[http://lifeinthefastlane.com/ccc/senkstaken-blackmore-and-minnesota-tubes/ LITFL: Sengstaken-Blackmore and Minnesota Tubes]		*[http://lifeinthefastlane.com/ccc/senkstaken-blackmore-and-minnesota-tubes/ LITFL: Sengstaken-Blackmore and Minnesota Tubes]
	*[http://emcrit.org/procedures/blakemore-tube-placement/ EMCRIT: Blakemore Tube Placement for Massive Upper GI Hemorrhage]		*[http://emcrit.org/procedures/blakemore-tube-placement/ EMCRIT: Blakemore Tube Placement for Massive Upper GI Hemorrhage]
	~~</div>~~

Jhattery: Created page with "'''PERLAS CLINICAS''' *No es necesario utilizar llaves de 3 vías/adaptadores de árbol de Navidad, solo aplique pinzas de Kelly a todos los puertos excepto el sitio de inflación gástrica Inicialmente intentamos encontrar todos los adaptadores, etc., pero terminamos teniendo fugas de aire porque no estaban conectados correctamente o no eran del tipo correcto y el balón gástrico no se mantuvo inflado. No use nada más que pinzas de Kelly Puede conectar la succión..."

2026-02-01T01:15:56Z

Created page with "'''PERLAS CLINICAS''' *No es necesario utilizar llaves de 3 vías/adaptadores de árbol de Navidad, solo aplique pinzas de Kelly a todos los puertos excepto el sitio de inflación gástrica **Inicialmente intentamos encontrar todos los adaptadores, etc., pero terminamos teniendo fugas de aire porque no estaban conectados correctamente o no eran del tipo correcto y el balón gástrico no se mantuvo inflado. No use nada más que pinzas de Kelly **Puede conectar la succión..."

← Revisión anterior		Revisión del 01:15 1 feb 2026
Línea 81:		Línea 81:
	#Desbloquee el puerto de inflación gástrica, bombee 50 mL, luego bloquee de nuevo, luego bombee de nuevo, repita hasta que alcance un total de 10 veces		#Desbloquee el puerto de inflación gástrica, bombee 50 mL, luego bloquee de nuevo, luego bombee de nuevo, repita hasta que alcance un total de 10 veces

	~~<div lang="en" dir="ltr" class="mw-content-ltr">~~		'''PERLAS CLINICAS'''
	'''~~PEARLS~~'''		*No es necesario utilizar llaves de 3 vías/adaptadores de árbol de Navidad, solo aplique pinzas de Kelly a todos los puertos excepto el sitio de inflación gástrica
	*No ~~need to use~~ 3 ~~way stopcocks~~/ ~~Christmas tree adaptors~~, ~~just~~ Kelly ~~clamp all ports other than gastric inflation site~~		**Inicialmente intentamos encontrar todos los adaptadores, etc., pero terminamos teniendo fugas de aire porque no estaban conectados correctamente o no eran del tipo correcto y el balón gástrico no se mantuvo inflado. No use nada más que pinzas de Kelly
	**~~We initially tried to find all the adaptors~~ etc., ~~but ended up having air leaks because they were not connected correctly or the right kind and the gastric balloon did not stay inflated~~. ~~Don't~~ use ~~anything other than~~ Kelly ~~clamps~~		**Puede conectar la succión a la succión gástrica, pero en general, ignore todos los puertos excepto la inflación gástrica.
	**~~Can connect suction to gastric suction but in~~ general, ignore ~~all ports other than gastric inflation~~.		*No es necesario utilizar el tubo esofágico o el manómetro, ya que la mayoría de las veces el tamponado gástrico será suficiente y no se quiere correr el riesgo de inflar demasiado el esófago
	*No ~~need to use esophageal tube or manometer as MOST of the time the gastric tamponade will be sufficient and you don’t want to risk over inflating the esophagus~~		**Haga que alguien cuente con usted para no perder la cuenta de cuánto aire ha insertado
	**~~Have someone count with you to not lose count of how much air you’ve inserted!~~
	~~</div>~~

Jhattery: Created page with "===Blakemore==="

2026-02-01T01:15:15Z

Created page with "===Blakemore==="

Show changes

Jhattery: Created page with "==Contraindicaciones=="

2026-02-01T01:10:19Z

Created page with "==Contraindicaciones=="

Página nueva

<languages/>

==Indicaciones==

*Paciente inestable con hemorragia gastrointestinal superior masiva y alguno de los siguientes:
**Incapacidad para realizar endoscopia
**Endoscopia fallida (p. ej., no se puede visualizar la fuente debido a la hemorragia intensa)
**Retraso en la endoscopia o consulta de gastroenterología
**Necesidad de estabilizar antes de la transferencia

==Contraindicaciones==

*Estricura esofágica
*Cirugía reciente del esófago o estómago

==Equipo Necesario==

<div lang="en" dir="ltr" class="mw-content-ltr">
*Balloon device
**Sengstaken-Blakemore Tube
**Minnesota Tube
*60 cc syringe
*Padded(tape) kelly clamps
**Used to clamp gastric and esophageal balloon ports to maintain precise pressure/volume
*Manometer
*3-way connector device
*NG tube (only for Sengstaken-Blakemore)
*Kerlex
*IV pole
*1 L bag IVF
*May need Magill forceps for manoeuvring tube into the esophagus
</div>

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==Procedure==
</div>

<div lang="en" dir="ltr" class="mw-content-ltr">
===Blakemore===
</div>

<div lang="en" dir="ltr" class="mw-content-ltr">
[[File:Sengstaken-Blakemore Tube.png|thumb|Sengstaken-Blakemore Tube]]
[[File:Sengstaken-Blakemore.png|thumb|Sengstaken-Blakemore Tube]]
https://www.youtube.com/watch?v=NHelCd5Jtp4
#[[Special:MyLanguage/Intubate|Intubate]] patient
#Fully inflate and deflate each balloon using its respective port to check for leaks
#If using Sengstaken-Blakemore tube, secure NG tube to tamponade device with distal end of NG tube 3 cm proximal to esophageal balloon
#Use NG tube to measure 50 cm from top of gastric balloon on Sengstaken-Blakemore tube, and mark 'G'
#Use NG tube to measure 50 cm from top of esophageal balloon on Sengstaken-Blakemore tube, and mark 'E'
#Attach 3-way stopcocks to esophageal and gastric ports
#Insert tube orally (may need to use lubrication and Magill forceps) to > 50 cm
#Test for location in stomach by injecting air through the tube and auscultating at the epigastrium
#Inflate gastric balloon (port marked 'G') with 50 mL of air
#Confirm location of gastric balloon in the stomach using portable XR
#Completely fill gastric balloon
#*Sengstaken-Blakemore: 250-300cc
#*Minnesota: 450-500cc
#*Measure the pressure at each 100 mL increment
#**If pressure is >15mm Hg more than corresponding pre-insertion pressure deflate the balloon and advance further prior to filling gastric balloon
#Tie tube to casting sleeve/Kerlex attached to a 1L bag of normal saline, and hang bag over IV pole to provide 1 kg traction
#Attach esophageal and gastric aspiration ports to suction
#If bleeding continues, inflate the esophageal balloon
#*Inflate to 20-40 mm Hg (use manometer to test pressure)
#*Do not inflate more than 45 mm Hg
</div>

<div lang="en" dir="ltr" class="mw-content-ltr">
===Minnesota===
</div>

<div lang="en" dir="ltr" class="mw-content-ltr">
https://www.youtube.com/watch?v=4FHIiA_doWU
#Get the kit, 4 Kelly clamps, 50 mL syringe, lube
#Take out nasogastric tube, if present
#*Nasogastric tube depth can be used to estimate how far to place Minnesota
#Clamp all ports on Minnesota EXCEPT gastric inflation and suction with Kelly clamps
#*Take out the little white stoppers in all the ports
#*If this takes a long time you can just leave in and clamp below if there is space
#*Put gastric suction to suction
#Test the gastric tube with air to see that they inflate in water bath
#Insert lubed tube to 50-60 cm mark (estimate bridge of nose to xiphoid process) and test pump 50 mL air then get a [[Special:MyLanguage/KUB|KUB]] to verify position
#Then count carefully to 9 more pumps of 50 mL (Minnesota gastric tube holds 500cc, you need 9 more pumps after the initial 50 mL.
#*have someone count with you)
#Unclamp the gastric inflation port, pump 50 mL, then re-clamp, then pump again, repeat until you hit 10 total times
</div>

<div lang="en" dir="ltr" class="mw-content-ltr">
'''PEARLS'''
*No need to use 3 way stopcocks/ Christmas tree adaptors, just Kelly clamp all ports other than gastric inflation site
**We initially tried to find all the adaptors etc., but ended up having air leaks because they were not connected correctly or the right kind and the gastric balloon did not stay inflated. Don't use anything other than Kelly clamps
**Can connect suction to gastric suction but in general, ignore all ports other than gastric inflation.
*No need to use esophageal tube or manometer as MOST of the time the gastric tamponade will be sufficient and you don’t want to risk over inflating the esophagus
**Have someone count with you to not lose count of how much air you’ve inserted!
</div>

<div lang="en" dir="ltr" class="mw-content-ltr">
==Complications==
</div>

<div lang="en" dir="ltr" class="mw-content-ltr">
*Due to misplaced balloon, migration, over-inflation, prolonged use
**Mucosal ulceration
**Aspiration
**Airway or large vessel obstruction
**Esophageal rupture
</div>

<div lang="en" dir="ltr" class="mw-content-ltr">
==See Also==
</div>

{{GI bleeding pages}}

<div lang="en" dir="ltr" class="mw-content-ltr">
==External Links==
</div>

<div lang="en" dir="ltr" class="mw-content-ltr">
*[http://lifeinthefastlane.com/ccc/senkstaken-blackmore-and-minnesota-tubes/ LITFL: Sengstaken-Blackmore and Minnesota Tubes]
*[http://emcrit.org/procedures/blakemore-tube-placement/ EMCRIT: Blakemore Tube Placement for Massive Upper GI Hemorrhage]
</div>

<div lang="en" dir="ltr" class="mw-content-ltr">
==References==
</div>

<div lang="en" dir="ltr" class="mw-content-ltr">
<references/>
</div>

<div lang="en" dir="ltr" class="mw-content-ltr">
[[Category:Procedures]]
[[Category:GI]]
[[category:Critical Care]]
</div>