Difficulty Aspirating NG Tube

[rachelgeorgina]

I am hoping someone can shed some light on this. I've not worked a lot with NG tubes before (I typically work with profoundly disabled kids who have G tubes) however I've come into a situation where NG tubes are more commonplace and I'm having a bit of trouble with them, even after reading all my texts and speaking with my educator etc.

In particular I'm having trouble aspirating stomach contents via an NG tube. When I pull back on a tube with a syringe the syringe will typically come up empty, with just air in it. If I flush the tube with 10mL of fluid and then pull back I can get the same fluid back (typically about 3/4 of it) with what looks like some feed in it - but I can't get pure gastric contents on plain aspiration.

Where have I gone wrong? Can any point point me in the right direction or in the direction of some useful literature. My texts are failing me on this one!

[rachelgeorgina]

Thanks a lot for your comments and feedback. I'm going to keep all of these things in mind next time I encounter this problem.

[danegerous, BSN, RN]

For a little bit of info, I had an NG tonight that was inserted by a competent nurse, and an x-ray was done (it's standard procedure here to obtain an x-ray for every tube placement). The x-ray read that it could use about 15cm further advancement to be appropriately placed. I went in there to advance the tube and low and behold, the tube was in his mouth!

Bottom line, those things can move!

[danegerous, BSN, RN]

PS - I just reinserted that same NG (like 4 minutes ago), and got NO gastric contents, but I did get a positive auscultation, and the xray is being done in a minute. It's possible it's in a little far, but the x-ray will tell me that and I'll adjust accordingly.