I posted a guestion in the Gastro forum R/T assessing proper placement of a PEG/PEJ. I may be crazy, but I always thought to check placement of a PEG/PEJ you measure external tube length, residual, and if you have any real concerns about placement you get an X-ray. Somebody told me you check by inserting air. I know an NG tube is assessed with air instillation, but a PEG/PEJ? I've searched and searched to find out. Please, Someone...tell me where or how I can find any literature that says you use air. All I find is measurement. Thanks in advance!
my replies on the Gastro forum said air because that is how they do it at their facility. I would like nursing research, professional association, or published nursing procedures to confirm the proper procedure.
Mar 10, '04
If the PEG/PEJ is displaced where would it be displacwd to? The peritoneal cavity. Which, inturn, would still give you air sounds when you instill air to assess placement. Sorry that I am harping on this subject, but I really would like published/written proof about how to assess proper PEG/PEJ tube placement.
Apr 16, '04
we get several in the er a month to replace because the "just popped out at home or the nursing home" we just a g tube back in slide it till you fill the pop and shoot a gastrograph to verfiy
Jun 30, '04
When in doubt xray. Instilling air is not going to give you any information. THe tube length should be measured, and the patient's bowel status assessed--is abdomen distended? Are there good bowel sounds? BM's? Most PEJ tubes should be sutured into place they are inserted to prevent aspiration for high risk patients or those whose stomach is no longer working properly. Does your facilities policies and procedures manual state that you should check for placement with air?? Sounds like a good topic for you to research if there is not a good policy in place. A PEJ feeding will be instilled at a slower rate than a PEG because it is entering the small intestine.
Also PEG is different from PEJ. A PEG is a gastric tube and you would check for placement. By instilling air and ascultation or some places will check PH level--some older methods of placing tube in water to see if it bubbles are not as effective. Again the best method for placement is xray.
Last edit by zumalong on Jun 30, '04
Jun 30, '04
Well in nursing school we was taught to instill 30 cc air (measured in the piston syringe) listen with your stethascope in the epigastric area to hear the air going in. But most of the time I check for residual gastric juices. Checking the measurement wont work unless it is a permanet placement. The other lines float back and forth. :roll :roll :roll :roll :roll
Jul 1, '04
I was taught to measure tune length and aspirate contents to check GT/JT placement and to NEVER use air.
Jul 1, '04
The only 100% accurate assessment of any tube NG PEG or otherwise is x-ray. Saw a couple of articles quoting that.
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