Checking Placement of PEG

[BluntForceTrauma]

Is it necessary to check placement of a PEG tube?

[TazziRN, RN]

Yes, or you could infuse stuff into the abdominal cavity.

[IngyRN]

How long is this necessary? Patients who have had them for a long time do not check placement at home, yet once they are admitted is it expected to chk placement.

[TazziRN, RN]

Standard of nursing care. A pt can receive injections at home by a relative, but when in the hospital we usually don't allow the family anywhere near the sharps. Would you want to be responsible for a displaced tube just because the pt's had it for a long time? Tubes are always capable of dislodging.

[txspadequeenRN, BSN, RN]

i don't care if a patient has their tube 5 min or 50 years if i'm the nurse it's getting checked.

[CarVsTree]

Perhaps a dumb question, but how do you check placement?

[TazziRN, RN]

Aspirate. If you get gastric contents, you're in. If you get nothing it's either dislodged or clogged. If you look at the tube and you can see a line of demarkation (the part outside the body will be dry and dark, the part under the skin will be paler and moist), with space between the demarkation and the skin, it's dislodged.

[TazziRN, RN]

Whoops......the response I put in here belonged on another thread!

[OhioMTCRN07]

We use air bolus but testing contents by pH is much more accurate. I would never, ever give anything down a PEG without checking placement.

[IngyRN]

Sorry if that was a stupid question. Please dont make me feel so terrible, I was simply asking if there is some standard where you no longer need to check placement. Thanks.

[TazziRN, RN]

Nothing wrong with your question!!!

[leslie :-D]

Sorry if that was a stupid question. Please dont make me feel so terrible, I was simply asking if there is some standard where you no longer need to check placement. Thanks.

ingy, caring for people in their homes is a whole different ballgame than caring for someone in a hospital/snf.

as long as someone has a fdg tube, placement will always have to be checked.

it's just too darned easy for it to migrate.

were you the one who asked how to do it?

many nurses instill approx 10cc of air in the tube while holding the stethoscope over the stomach.

when you hear the 'whoosh', then you know the tube is where it should be.

a more reliable method is checking gastric pH, by aspirating a small amt of residual and placing it on litmus paper.

the pH should be less than 4.

the most reliable (and in some facilities, the only acceptable way) method is by xray.

don't hesitate to share any and all questions.

leslie