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Discussion

Checking placement of Gtube

What do all y'all do to check placement of a G Tube? I've always just seen 'instill air and listen for the whoosh'. My new facility is telling me our policy is to aspirate and look at the color and then check the pH of the liquid. Anyone else doing this? Last time I had an issue with GTubes was 2 years ago when the DPH didn't like the fact that we had no order to check placement.

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    As far as I learned i school the pH check is the gold standard for checking placement. The last facility I worked for did not even have the materials to check this way, so we used the instill air method. Checking the color seems rather unreliable to me.

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    My CMS F-tag book (F693) notes that "Auscultation is no longer recommended for checking placement of the feeding tube. Movement of air would likely be heard whether the tube was in the correct or incorrect location. X-ray confirmation is the most accurate method for verification of tube placement when concerns arise regarding dislodgement or placement..." It goes on to give a website but when I tried to check it before posting this, it appears to be no longer valid (Resource Library | Institute For Safe Medication Practices)

    The guidance I received from a leading age representative at our annual seminar was basically to check gastric contents and if we have any real concerns about placement then we need to send out for an X-ray.

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