Upper Gastrointestinal Haemorrhage

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Balloon Tamponade Procedure

Upper Gastrointestinal Haemorrhage Non-Medical Therapy Balloon Tamponade Procedure
  1. Ideally secure the patients airway with endotracheal intubation
  2. Ensure the tube is intact, check both gastric and oesophageal balloons by inflating each with 50ml or air and deflate both fully
  3. Spigot the aspiration ports
  4. Lubricate the tube
  5. Insert the tube to at least 50cm via the mouth and remove the guidewire. If the guidewire cannot be removed easily pull the tube back to 45cm and try again, if unsuccessful then remove the tube and reinsert
  6. Inflate the gastric balloon in 50-100ml increments up to the maximally recommended volume (250-400ml depending on the tube). Do not routinely inflate the oesophageal balloon
  7. Pull back on the tube and secure with a rope-and-pulley system with a 500ml bag of fluid for weight, or to the mouth with a tongue depressor and padding system
  8. Arrange an urgent portable chest XR to confirm the position
  9. The oesophageal balloon should only be inflated if bleeding continues (inflate to 40mmHg)

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