abelm

This is a frequent question that comes up when we teach Enteral Feedings. The text that we use "Fundamentals of Nursing" 2nd ed Wilkinson & Treas states on pg 640 "NG and NE feeding tubes are placed without direct visualization. As a result, there is risk of placing the tube into the respiratory tract. Therefore, you must check the location of the tip of the feeding tube before each enteral feeding or once per shift for continuous feedings". They go on to address the bedside methods one might use. They do not address G-tubes and one might assume then that G-tubes do not require verification of placement on an ongoing basis (when place by the physician, placement is verified). The old saying was "if it isn't in the stomach, it is in the bed". I have heard anecdotal reports of g-tubes migrating out such that the feeding is trying to infuse into sub-Q tissue. It seems to me that inspection prior to a feeding & routinely (q8h), would alert one that something is wrong - redness, drainage, edema at the site. As for any tube feeding you need to check residual (before a feeding or q8h) this would support (or place in question) if the tube was in place. Further, it seems that if you were to woosh 20 - 30 ml of air into the sub-Q tissue, this would only further damage tissue. Open to any other thoughts!