Reply To: NG tube placement

  • Kathleen Stakes

    Member
    October 24, 2014 at 9:48 am

    We do a chest X ray for initial placement.  If a child needs the NG for a long time we will have a g tube placed. 

    ——————————————-
    Kathleen Stakes
    Massachusetts General Hospital
    Winchester, MA
    United States
    ——————————————-

    ——————————————-
    Original Message:
    Sent: 10-23-2014 01:40 PM
    From: Amanda Ebbert
    Subject: NG tube placement

    We are currently working to revise our policy on NG tubes. Currently, initial and ongoing placement in most instances, is verified via air bolus and auscultation. As I’m sure you all are aware, X-ray is noted as the gold standard for verification of initial placement. All of the literature I have found also notes the risk of radiation exposure and discusses checking pH to verify placement. I have a few questions for you:

    1. How do you verify initial correct placement of NG tubes?
        a. Is it different for certain populations of patients or for decompression verses feeding?

    2. How do you verify ongoing correct placement?
       
    3.  If you use pH as a guide, what pH level is acceptable for determining correct placement?
         a.  Is there a difference for patients on feeds or taking meds for acid suppression?

    4. Do you allow parents to drop NG tubes at home if they are pulled out/come out?
        a. If yes how do you have them verify initial placement?
        b.  Is what they do at home different than what you do in the hospital?
        c.  How do you have them verify on going placement prior to meds or feeds?

    Thanks for your help

    ——————————————-
    Amanda Ebbert
    Clinical Nurse Educator
    Penn State Hershey Children’s Hospital
    Hershey, PA
    United States

    ——————————————-
    Amanda Ebbert
    Hershey, PA
    United States
    ——————————————-