Do you auscultate your NGs?

[Carpediem1012]

I am just wondering how many here auscultate to check tube placement in their patients with nasogastric tubes meant for feeding or med administration. If not, how do you verify placement in the stomach? (And this is not a homework question haha). I have recently written a paper on the topic and wonder who is using each method.

[VANurse2010]

We always confirm placement with a KUB initially. I auscultate during morning assessment in addition to checking for residuals. For the rest of the shift, I just check for residuals and check what cm mark it is at in the nare. This is how I was taught.

If it's been confirmed by Xray and the cm mark hasn't changed, I don't even bother ascultating. I may or may not check residuals depending on how long the patient has been there and how long their tube feeding regimen has been in place.

[Friskee, BSN, MSN]

I was also taught that auscultation in itself is not accurate. It is acceptable with other interventions to confirm placement. If we are dealing with a preexisting NG tube that has already been verified by imaging, we just need to aspirate, assess PH and check residual volume before any administrations of medication or bolus feedings.

[OCNRN63, RN]

I used asp for gastric contents and auscultation prior to verifying with imaging.

[OneDuckyRN]

In facilities that allow Dobhoff tube insertion by the RN a CXR has always been the standard for placement. The tube is small and doesn't produce enough of an "air" sound.

We always get XR confirmation before using the Dobhoff...when I auscultated for placement, it was more for my own curiosity than anything else because the tube went down FAR too easily, in my opinion.

[JWG223]

I am just wondering how many here auscultate to check tube placement in their patients with nasogastric tubes meant for feeding or med administration. If not, how do you verify placement in the stomach? (And this is not a homework question haha). I have recently written a paper on the topic and wonder who is using each method.

Yes, every shift. However, initial placement is verified via XR. You fail to auscultate that NGT (or use whatever method you are told to at your facility) and it ends up filling a lung with Nepro, and you have an easily preventable death/professional consequences/guilt for being a lazy slob for the rest of your life.

[K+MgSO4, BSN]

I know the one I dropped for decompression was correct tonight. 1.3L out in 10min!

For feeding tubes fine bore pH aspirations onto indicator paper not litmus paper. CXR for confirmation as well. 8hrly tape measures from nose to end of tube to observe for dislodging.

[bluejay4224]

Thank you for this great post.

[calivianya, BSN, RN]

We auscultate when first dropped, get a KUB per protocol for placement (can order this without asking a physician if there is an order for a NG/OG to be dropped in the first place), and then I auscultate q4h. I'm checking tube feed residuals q4h anyway so it's not like it's an extra step.

[Kipahni, RN]

residual and x-ray to verify tube placement