[danissa]

hi all, I'm new to posting on site. I'm Dee, neonatal midwife from Scotland, just finished intensive care modules. Luv the job!! I have three teenage children( taking exams and fighting me for space at computer!), one hubby, one dog, one hamster, life is pretty nice just now! Have been looking into the use of pH versus litmus paper for testing gastric aspirate in neonatal population, (we use litmus), is anyone using pH paper for neonates? Any advice/ recommendations etc. would be great!

[BittyBabyGrower]

No, we don't do that....we will occasionally send stool for a pH if the kid is dumping. Why do you guys test it with litmus?

[danissa]

Originally Posted by BittyBabyGrower

No, we don't do that....we will occasionally send stool for a pH if the kid is dumping. Why do you guys test it with litmus?

hiya bittybabygrower, nice to get a quick reply! (and wish I had used such a fab name!) anyway, we use litmus paper to test for an acid reaction prior to gastric tube feeds( pink then feed), but new guidelines in england and wales are recommending use of pH paper. not really practised yet in scotland though, that,s why i'm trying to get some info. Are you in UK?

[sparkyRN]

Originally Posted by danissa

hiya bittybabygrower, nice to get a quick reply! (and wish I had used such a fab name!) anyway, we use litmus paper to test for an acid reaction prior to gastric tube feeds( pink then feed), but new guidelines in england and wales are recommending use of pH paper. not really practised yet in scotland though, that,s why i'm trying to get some info. Are you in UK?

Interesting. Are litmus/pH papers a means for checking that the OG/NG tube is in place? We do not do that here. Our unit's protocol is to do a lip to ear to xyphoid measurement then place the tube. We check placement by auscultation--pushing 0.5cc of air and listening over the stomach. Then we aspirate back the air and any fluids.

[Gompers]

I don't know that pH testing would do us a whole lotta good - just about every baby on the unit is on Zantac!

[dawngloves]

We've been doing this for over a year now to check placement. We are notto use ascualtation before a feed, only for new placement. A pH of 6 or less is indicative of good placement. If I get no aspirate I do asculatate even though policy says to inject air and then you'll get some aspirate.

[RN4BABES]

We used to test pH but now we don't.We measure tip of nose to ear to xiphoid, insert and secure NG then put end of tube into bit of water to see if there are bubbles (I think we are the only ones who do this step) check for aspirate then check "pop" by inserting 1 cc of air and auscultating over stomach.

[Leofric]

hi. I am in Lincoln , Uk NNU and we are still using litmus, though are looking at going over to PH paper. We are not allowed to auscultate as it is possible on the smaller babies to hear the air and think its in the stomach even though it may not be! ( allegedly!)
I am really surprised to hear that so many american units dont check for an acid reaction... again, a case of differing practices! i usually find just repositioning the baby and / or pushing air in does the trick ( unless your feed is late and they have absorbed it all lol!

Ps We are currently looking at more effective ways of securing the tubes... we currently use a base of duoderm to protect skin ( this stays insitu) then secure with either mefix ( white permeable tape) or opsite ( clear, thin dressing), just taped along one cheek, but they are always coming off!

[Gompers]

I think the reason we don't check a pH on my unit is because the vast majority of our kids are on Zantac or Prevacid/Prilosec to decrease stomach acid and control reflux. The pH is altered and not reliable for us.

I personally think that moustache taping works better for NG tubes. The ones taped to one cheek only seem to come off much easier in my opinion. Either it gets pulled when the baby turns his/her head, or the baby uses fingers to pull at the bit of tubing between the nare and tape, and then the tube is out! Might not be as cute, but moustache taping is more secure and harder for the baby to rip out. We either use comfeel/duoderm and cloth tape, or just the pink hy-tape for our moustache jobs.