Contributor: Dylan Luyten, MD

Educational Pearls:

• To place a Blakemore/Minnesota Tube:
• • Insert into esophagus under visualization
  • Inflate gastric port with 60 cc of air and obtain a chest xray to ensure the balloon below the diaphragm
  • Once confirmed, place a total of 500cc of air into the gastric balloon via the gastric port
  • 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
  • Now the the tube is in place under traction, attach a manometer to the esophageal balloon port
  • Provide low pressure to tamponade a variceal bleed, which is about 33 mmHg
• This is a temporizing measure and often patients need to get a Transjugular Intrahepatic Portosystemic Shunt (TIPS) from interventional radiology for more definitive treatment

References

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/

Amazing video of placement by EM:RAP ProductionsPlacement of a Minnesota Tube for Bleeding Varices

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account.

Donate to EMM today!