Aspirating air while checking for gastric residual

[Daliadreamer]

Hi everyone,

I took care of a patient that had a PEG replaced the day before because his previous PEG was leaking. Patient was post CVA a few months ago and in the hospital now for hypoxia, non verbal. Everyone was going well with his feedings. When I went to check his gastric residual, all I was pulling into the syringe was air. I pulled three syringes of air before I stopped (because I was just amazed at what was happening). There was no resistance when I aspirated. I asked some of the other nurses on the floor if they had ever heard of such a thing happening, because I was very confused, and no one had an answer for me. Luckily, his GI doctor was calling the unit at that exact minute asking about another patient, so I told her what was going on. She also sounded confused, told me to stop the feedings and she would re-evaluate the patient in the AM. I am off today, and just curious what could have happened.

Has anyone ever had this happen? Could the PEG be dislodged? I admit I did not auscultate the placement of the tube during this time via air because I was afraid I would do some damage if something was wrong with the tube.

Thanks!

[Esme12, ASN, BSN, RN]

Peg tubes should drain to gravity gastric contents...while some air is OK.....like a burp I would not insert meds/feedings nor flush one with saline that has no residual content. I would stop clamp and call the MD.

You did good....it is entirely possible it isn't where it belongs.