Nässvalgsond på hund – djursjukskötarens område?

Sammanfattning: The aim was to identify if the veterinary nurse is as competent as the veterinaian in placing a nasoesophageal feeding tube. The aim was also to identify the complications with malnutrition and the advantage and disadvantage of the procedure. This essay is based on several interviews with both veterinary nurses and veterinaries. 16 persons were asked 4 short questions in conjunction with an intensive care/emergency and surgery congress in Gothenburg in February 2013. In addition 4 major hospitals that provided intensive care were asked to answer 5 more detailed questions, one answer from a veterinary and one answer from a veterinary nurse was requested. A literature study were conducted to learn about the advantages and disadvantages with nasoesaphageal feeding tube and malnutrition. The interviews showed that the majority of the respondents believed that more hospitalized dogs are in need of nasoesophageal feeding tube to prevent malnutrition and to help them recover. The majority also believed that veterinary nurses as well as veterinarians could perform the placing of the nasoesophageal feeding tube, provided that the veterinary nurse possessed skill in the procedure. Complications seen with malnutrition in hospitalized dogs are severe. The aberrant metabolism seen in critically ill patients result in lean body mass lost that may progress to hyper metabolism which may lead to multiple organ dysfunction and death. Nutrition will propone the immune system and healing of body tissue. The nasoesophageal feeding tube has several advantages. The major one is the prevention of a possible malnutrition or if malnutrition is already present, intercept the condition in time. The procedure is relatively easy to perform and the dog does not need routine sedation, which is an advantage in critical ill patients that cannot undergo anesthesia. The disadvantages that are seen along with the nasoesophageal feeding tubes are epistaxis and irritation in conjunction with the placement. The tube may be introduced into the trachea, however this should not be of any concern because of the mandatory x-ray before feeding is introduced. Gastrointestinal complications as vomiting and diarrhea are also seen, often related to the wrong food administered to hastily, at a too cold temperature, or because of a too large quantity. As conclusion for the patients well-being, malnutrition should be avoided when hospitalized. Hence, the advantages with the nasoesophageal feeding tube outweighs the disadvantages for patients who are expected to need nutritional support for a short amount of time and/or are not in a condition for anesthesia. Both the veterinary and the veterinary nurse are competent to place the nasoesophageal feeding tube and there is not any legally impediment. The belief is that more dogs in need of a feeding tube would have it placed if the procedure was delegated to the veterinary nurse.