MD order

[rnpete]

New nurse here. Do you require an official MD order to use an ng tube after the Xray has been done to confirm placement.

[Rose_Queen, BSN, MSN, RN]

What does your facility policy state? That would be where I would go for an answer since this may vary from facility to facility.

[Here.I.Stand, BSN, RN]

We don't use NGs for feeding, only NJs, but yes as soon as the xray is done the MD enters a "line/tube okay to use" order into Epic. Same thing for CVCs and PICC lines

[MunoRN, RN]

I've never worked at a facility that required an additional order after the xray to use the tube, it doesn't really make sense to me why that would be necessary since they've already specified where they want the tube in the order, but there are places that do so I would familiarize yourself with your facility's policy.

[ArrowRN, BSN, RN]

Refer to your facility policy on NG tubes...At our facility the MD also has to write an ok to use NG or NG tube cleared for use order. They are the ones who have to review the x-ray anyways, its confirmation that no further adjustments needed...if you dont get that confirmation written I wont use it.

[DextersDisciple, BSN, RN]

On my unit we usually have OG tubes, which do not usually require X-ray. We confirm placement by pushing 40mL of Air into the tube and auscultate the stomach to hear the "whoosh".

NGT are not too common where I work so I don't know about that. However we do use an NG style tube known as a DOB Hoff tube. Dob Hoffs are much thinner and have a stylet inside. MD Places these then CXR and finally an "ok to use dob hoff" order. The RN is then allowed to remove the stylet.