NG/OG tube verification policies

[Sue Hinds]

Does anyone have a written NICU policy for NG/OG tube verification they are willing to share?

I know a Chest Xray is best gold standard to be sure the NG or OG is correctly positioned....

but in the NICU we are not going to expose the neonate to repeated radiation and there seems

to be a variety of nursing opinion about how best to check placement before feedings.

Auscultation, pH testing, gastric contents, tube length measurement and marking the tube are

frequently recommended but I really want to hear what NICU nurses really are doing!

Thank you, Sue

[NeoPediRN]

We just auscultate before each round of meds or bolus feeds. Checking the pH isn't really helpful if you have a baby on a continuous feed because the pH of most formula is similar to the pH you'd find in the intestinal tract. If the tube comes out we replace it, have two nurses verify placement, and do check a pH, which, as I said, isn't always helpful.

[NeoNurseTX, RN]

Aspiration, auscultation.. not the gold standard but the most cost effective. NDs are by xray.

[PrudenceNurse]

We don't have a written policy (perhaps we should), but we teach that aspiration is the best way to verify placement. Auscultation is not very accurate, especially in the micro-preemies, because if the tip of the tube is in the esophagus, you can still hear the air when you listen over their stomachs.

[dawnebeth]

Our tubes have numbers on them. We're supposed to check the number at the lip or nares every shift (who now remembers that I checked the number at the lip last night and never wrote it down on my notes). Pushing air into a small baby isn't always the greatest idea, especially a baby who already may gulp air or be on Nasal CPAP which blows air into the stomach.

Drawing back stomach contents is always a good indicator, as well.