NG tube

[rehanna123]

Am doing NG tube procedure.

Now the procedures to confirm its placement are

1. pH testing- Should be less than 4 ( as of gastric contents)

2.auscultation - instilling air in and listening through the stethoscope

3.X- ray ( on initial placement)

4.Aspirate- colour

Now am looking for their limitations as well..some i have found..

1.it does not give the confirmed location of tube because of mismatch of pH ( is that right?)

2.Bubbling in air...the tube could be in lungs and sound heard sounds similar to the one we listen in stomach, so not confirmed

3. x- ray ( i did not get that)

4. aspirate ( do not know)

please guide the missing links...And confirm the rationales I know.

[CrazierThanYou]

I had to do a thing on NG tube placement verification last semester and I was told that instilling air is no longer used. Don't take my word for it, though, that's just what MY instructors said.

[rehanna123]

Yup ....i Know..but still hospital uses them..because x ray can be done only on referral by dr and thats also only once...

[nickster10]

im doing that know too (test on monday)

to verify placement..

you check the ph (your looking for anything less than 5, b/c gastric secretions are acidic)

you aspirate( to look for stomach contents or if they're on tube feeding you can see the actual feeding)

and in our school we have to measure the tube before we do anything ie. meds or feedings to make sure it didnt migrate

and if we do the air thing we have to back that up with something else like checking ph or aspirate but they said not to do that

i hope some of this helps

[xtxrn, ASN, RN]

Granted, it's been a while since I messed with NG tubes...but I always used air bolus/auscultation. You're right- the x-ray is by order, and only once (need new order if the patient pulls it out & you have to reinsert it).

Never did pH testing.

Aspirating stomach contents

Putting the end of the tube in a glass of water is not as accurate as the listening for air (it's a very distinctive sound).

Also, you can measure the length to go in - and mark it with a piece of tape on the tube; when you get it in as far as the tape, you can pause, and do your confirmation - but the tape is a way to mark the correct length. :)

Also- have a basin nearby (not a puny puke pan). :) It can get ugly It's not a pleasant procedure to have done- and going slowly until they can swallow is more humane than ramming the thing in there. Then you want to make the best of each swallow. :)

[milksteak]

We learned this semester that auscultation is very inaccurate and should not be used.. however, last year it was okay.

So things keep changing at the drop of a hat. I would verify with your instructor/boss.. not sure if you're in school or working.