Just wondering, what is everyone doing to confirm placement of their OG/NG tubes? X-ray? colorimetrics? with all feeds, once a day? everytime it comes out? any insite will help.
Apr 13, '10
We are supposed to check the pH of the aspirate, however, many of us double check via air bolus auscultation, then aspirate to check amount and pH. OG/NG continuous checked daily after feed held for 1 hour. Bolus feeds checked with each feed and meds, also check pH if the tube has to be replaced.
Apr 13, '10
Aspiration/auscultation with every feed/med. We don't check the pH though, if residual is greater than 2/3 the last feed, or a color it is not what it is supposed to be we hold on to it, don't feed and call the doc
Apr 15, '10
Currently aspiration/auscultation with each "event" so feeding or med. We are currently training staff to implement the ph litmus testing, so this will become the norm in the very near future. I'm not totally sold that it is necessary as I've never seen a tube go in the trachea in 13 years of nursing, seems that there are bigger fish to fry IMHO.
Apr 16, '10
Check placement with every feed or med given by making sure tube is at same measurement, air bolus pop, and aspiration. With continuous feeds, we check aspirates Q4 hours. We record residuals and alert physician if it is high. No pH testing at all.
Xrays are required for babies who are neurologically impaired/lacking gag relfex with every tube placement. Other than that, we do not have to get an xray.
Always x-ray for ND/NJ placement or if that comes out and we attempt to replace.
Apr 19, '10
Generally, we chart the number visible at the lip or nares in the chart every shift and on the kardex, and pull back aspirate to check placement. We only use x-ray if the tube is in the jejunum.
Apr 21, '10
Auscultation/aspiration on initial placement. Confirmation of position by number markings on the tube, as well as aspirate every feeding/assessment. Also confirm on each x-ray that's taken.
Apr 22, '10
Auscultation / aspiration upon insertion, and before each feed/med. X-Ray only if it's an NJ/ND. We also chart with each VS what cm the tube is at at the nares / lips.
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