NG tubes

[Emilysmom2, RN]

HI

I have not had to deal with a pt that has a NG tube in a long time. How do you check placement when pt is on continuous low suction? How would you flush it?

Thanks

[Piki]

We deal with NG tubes all the time on our floor (lots of bowel surgeries and bowel obstructions). To check placement we use audible air injection. You have to unhook the NG tube from the suction, remove the small cylinder thing that goes between the patient's NG tube and the suction tubing, and use one of the big toomey syringes to inject air while placing your stethoscope over their stomach. You should hear a big belching sound. To flush, we use normal saline. 45-60 ml of NS into the syringe, and then flush the same way you did for the audible air injection. Then reconnect the tubing.

I have never seen the aspirate method nor x-raying after NGT placement. We check placement at least q 8 hours on the floor. We also put in alot of NG tubes as well (RNs). Sometimes they come back from surgery with them placed.

Hope that helps.

[cardiacmadeline, RN]

In our facility, we do not inject air into NG tubes to check placement. This method is unreliable and is no longer considered best practice. You may still be able to hear air with your stethoscope even if the NG tube is not in the stomach. We don't place a lot of NGs on our floor, most of them come back from surgery with them. But if we do place them, we get an x-ray to check for placement before instilling any medication and feedings. We then measure them every 8 hours to check placement (similiar to the policy of measuring PICC lines). Hope this helps!

[NurseNighting]

You should be careful to read up on your hospital's policy and procedure if you are not certain. Steps can vary from facililty to facility and state to state.

At my hospital, everything is online, others still have the old binders, some P&Ps state that policy follows a nursing procedure text book's procedure - and this book is available on the unit to refer to, but this information should be readily available to you.

When in doubt, (i.e. can't find a P&P or your still have questions) I would ask for advice up the chain of command and possibly even contact education to see if they can help.

By following your hospitals P&P you are able to best protect your patient and your license from harm.

[RedhairedNurse, BSN, RN]

In our facility, we do not inject air into NG tubes to check placement. This method is unreliable and is no longer considered best practice. You may still be able to hear air with your stethoscope even if the NG tube is not in the stomach. We don't place a lot of NGs on our floor, most of them come back from surgery with them. But if we do place them, we get an x-ray to check for placement before instilling any medication and feedings. We then measure them every 8 hours to check placement (similiar to the policy of measuring PICC lines). Hope this helps!

Same at the hospital I work. I think xray is a must, I know if I had an NG tube, I would demand xray.

The above post surprised me that they don't do xrays. wow! That's very hard to believe.