Upper Gastrointestinal Haemorrhage

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Balloon Tamponade Procedure

Upper Gastrointestinal Haemorrhage Non-Medical Therapy Balloon Tamponade Procedure
  1. RSI should be undertaken to secure the airway
  2. Test the balloons on the tube to the maximally recommended volume, then fully deflate them
  3. Lubricate the tube, then pass orally to a depth of 50-60cm
  4. Insert air into the gastric aspiration port and listen with a stethoscope over the stomach and lungs. Inflate gastric balloon with 50ml air
  5. Confirm placement with chest x-ray (gastric balloon in stomach)
  6. Inflate the gastric balloon with air in 50-100ml increments up to the maximally recommended volume (250-300ml for SVT or 450-500 for Minnesota). Stop if resistance is encountered. Clamp the port
  7. Further x-ray to confirm position
  8. Pull balloon back against gastric fundus. Mark at the lips. Traction with 500ml bag of fluid and rope-and-pulley system
  9. The oesophageal balloon should only be inflated if bleeding continues (inflate to 40mmHg)
  10. The EMCrit blog has some further tips, as well as a video to help to explain the above steps more easily.
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