How do you verify NG tube placement on your unit?

bmsrn · Apr 3, 2012

We just aspirate or auscultate. When we chart, and it asks for how placement was checked one of the options is actually "remains at cm mark at nares"- something like that. We don't use pH at all. And we only use X-ray for OTPT, and after that we just check for snap back.

I think NICU is different then any other floor when it comes to OG/NG tubes. So many of our patients have them. Our LPN's can give feeds through them, but when we get floats- they won't even touch them, I guess on all other floors only the RN's can use them. It's kind of annoying because I have to feed their babies throughout the entire day.

digitiminimi · Apr 3, 2012

At our NICU we place, auscilate, pH. After that prior to commencing feeds or putting down any meds we x-ray. This is hospital policy.

Wow, every feeding or med administration? That seems really excessive.

Wanahakalugi · Apr 5, 2012

Auscultation for NG with residual and pH. Only redidual when newborn has nursed before admission to the floor.

We only x-ray if we have it placed with a neo that has lung issues.

When on med/surg, we x-ray every placement no matter what.

The little ones pull out their NG so much that we would be waaaaay over the exposure limit for them if we x-ray everytime.

wannabesedated · Apr 15, 2012

We check the pH of the aspirate. We sometimes x-ray if we don't get an aspirate or if it is greater than 6.

luvsnicu · Aug 13, 2012

We just measure and aspirate. No xray, ausculatation or pH checks. We used to auscultate, but told that it wasn't reliable. We will just check placement on the next xray, but would never get an xray JUST to check placement. And with how often babies pull them out - I can't believe hospitals still xrays every time! Especially when it seems like there are still a lot of hospitals who insert NG/OG's daily or even with each feed. Completely unnecessary procedures and tests if you ask me. If you put an NG/OG to the correctly measured depth and it went in the lung, you're going to know! You would certainly see the baby coughing or desatting, unless paralyzed/comatose. I would think auscultation could be somewhat useful, but even if the tube isn't quite to the stomach, I would think you're still going to hear air in the stomach when injected.