[pink2blue1]

Originally Posted by RN92

the pt could have aspirated. i know you probably reported it to the md, right? he should have ordered a chest xray. was the tube secured? and how? just curious.

Yes called the MD immediately, after cleaning the patient up and making sure he wasn't choking of course. Yes he ordered a chest x-ray. The tube "looked" secured and when I re-inserted a new ng tube, I did secure it with the tape on the nose, half split and wrapped around tube and back up to nose. Also left my tape marker on the tube. There wasn't a marker on the one I pulled.

[sanctuary]

Originally Posted by RedCell

I never stopped the TF until the patient spiked a fever! Seriously though, I believe the gold standard is to verify NG placement with gastric pH testing. I realize this is not available in all institutions. The craziest thing I have ever seen is a dude with a cribriform plate fracture who got a pneumocephalus and croaked from having an NG tube curled up in his frontal lobe after the nurse checked for placement with a 30cc air bolus. Made out to be a really cool skull X-ray.

I've seen that X-ray. Totally obscene. That's why a primary check should be an X-ray, not air... And BTW, I hate feeding pumps. (Antique nurse here.) Back In The Old Days, food was gravity fed, at meal time with the patient sitting up, either at the bedside, or if available, in a dining room. Food was a puree of what every body else was having, and poops were normal, not this semi-liquid diaper fill you get nowadays.

[jan Christian]

NGT placement should always be checked before each feeding not just every shift,thats what we do here at St.Pauls Hospital Iloilo,Philippines.you may introduce air or aspirate gastric contents to make sure it is properly placed in the stomach. Always assess before doing actions. use nursing process at all times.

[pattycakeRN]

Originally Posted by RedCell

I never stopped the TF until the patient spiked a fever! Seriously though, I believe the gold standard is to verify NG placement with gastric pH testing. I realize this is not available in all institutions. The craziest thing I have ever seen is a dude with a cribriform plate fracture who got a pneumocephalus and croaked from having an NG tube curled up in his frontal lobe after the nurse checked for placement with a 30cc air bolus. Made out to be a really cool skull X-ray.

Whaaaat? I googled that to find an example, and has apparently happened enough to have many a journal article written on the subject.
On that note, I wanna see!