NG tube placement and aspiration

[alexabur]

Hi all - new nurse here! My question - when checking for NG/OG tube placement by aspirating for gastric contents, should you ALWAYS get something? Can it be in the right place, but you get nothing when checking placement? Or is that a sign that you need to try to push it in deeper? I know it can get coiled up, or just not be in the stomach…but are there times you’ve had it checked with xray and it was in the correct place even though nothing came out when you aspirated to check for gastric contents? Thanks in advance!

[NICUmiiki, DNP, NP]

Getting stuck against gastric lining is probably why you aren't getting anything. Aspirating is right below auscultating the bubble on the list of non-evidence based (and fairly useless) practice. X-ray is gold standard (but we aren't gonna do that). Besides that, accurate measurement is the best thing you can do. Nothing else is studied enough. You probably have some sort of policy that states what you have to do, so do it (since it likely isn't harmful beside instilling false confidence) but just keep in mind that those practices likely don't "protect" the infant as the policy probably intended to do.

[alexabur]

Thank you so much for the response, @NICUmiiki!

[Leader25, ASN, BSN, RN]

On 7/10/2022 at 12:40 AM, alexabur said:

times you’ve had it checked with xray and it was in the correct place even though nothing came out when you aspirated to check for gastric contents?

The checking for placement does NOT depend on getting actual contents,you should be listening carefully with your steth,the whoosh of air sound and its location should be clear.Some push air in which I always refused to fill up a belly with multiple tries of air.Buy a good quality steth and ear plugs that fit ,and listen to the sound.You also premeasure the tube size before insertion.It behooves you to be well prepared to do your job correctly.