[morte]

Originally Posted by meownsmile

I have to concur with RNmi. I think when you are referring to the book and enteral feedings your book is explaining the placement of a naso-gastric tube which is completely different from a PEG. A PEG is a percutaneous tube placed through the abdomen and into the stomache. For a PEG to migrate to the lung it would as someone else said have to be completely sucked into the stomache and move up the esophogus to the trachea and go down. A PEG tube normally is no more than the length of a foley catheter. Or it would have to have punctured the diaphram on insertion to get to a lung. If it had the patient would immediately go into respiratory distress in surgery and you wouldnt see the patient back on the floor until the chest tube was out and the lung reinflated.
Dont throw your book away, and noone is trying to push any buttons, but i think you may have misunderstood your book.

thank you. thank you. thank you.

[TraumaGirl1018]

i dont see how in the world a PEG tube would migrate to the lungs...even if by some chance a lung was inadvertently pierced during PEG placement, it would be noticed pretty quickly..and even so, that wouldnt be considered "migrating", because it never "migrated" anywhere, it was directly placed there. By the time a pt with a PEG tube in a lung got to the floor, they'd probably be in serious trouble

[shrimpchips]

Originally Posted by kcalohagirl

that still begs the question, how would a PEG migrate to a lung?

It wouldn't.
The PEG tube can migrate to the duodenum, however. That's why you should check placement by injecting air into the tube to listen for that gurgle. Of course like Nrs_angie mentioned, the most reliable way to check placement is by xray. Another very reliable way is to check pH when you aspirate for residuals - the duodenum has a pH of ~6-6.5 while the stomach has a pH of ~1-2.

[catlvr]

THanks; there's a fair amount of dispute in our facility about where to place the stethoscope to determine placement - we all have a differnt idea! I'd love to find the "definitive" answer, since our facility policy doesn't offer it, and I haven't been able to find the answer.

TIA,

e

Originally Posted by shrimpchips

It wouldn't.
The PEG tube can migrate to the duodenum, however. That's why you should check placement by injecting air into the tube to listen for that gurgle. Of course like Nrs_angie mentioned, the most reliable way to check placement is by xray. Another very reliable way is to check pH when you aspirate for residuals - the duodenum has a pH of ~6-6.5 while the stomach has a pH of ~1-2.

[shrimpchips]

Originally Posted by catlvr

THanks; there's a fair amount of dispute in our facility about where to place the stethoscope to determine placement - we all have a differnt idea! I'd love to find the "definitive" answer, since our facility policy doesn't offer it, and I haven't been able to find the answer.

TIA,

e

Generally the stethoscope is placed next to where the tube is inserted/next to the dressing (but not touching it, of course) on the abdomen - or at least that is how I was taught.