10 replies to this topic

[nursenut23]

I was just curious how your hospital or nursing school teaches to varify placement of an NG tube. In my nursing school in maryland we were taught to asculated the abdomen while pushing air through the tube and if you hear a swoosh you were in the stomach and to be double sure check for gastric content. However when I started working just 3 months later in Ohio the hospital policy is that you have to leave the guide wire in the NG tube and then order a xray to varify placement. When I questioned it they simpled said "we don't do that anymore" I was just surprise that in 3 months that had change. So I'm curious to see what you all do?

[3boyzmom]

I work in a hospital-based clinic and we don't do them there, but I believe in our hospital they still get an x-ray to verify initial placement, and then prior to each feeding (med admin, etc) you auscultate as you described. For continuous feedings, I can't remember how often they check by auscultation, but I am pretty sure that they do check after initial placement with an x-ray.

[Abbeygirl]

If you are placing a tube in an emergency you can still auscultate with air then get X-ray. If you are in the home where no X-ray is available and replacing a tube you will have to auscultate. X-ray is always best, but sometimes in the real world you may not have it available and need to know what to do without it. Some nurses get so used to relying on the easier ways they forget what to do in an emergency. I know a feeding tube is not an emergency procedure, but like I said, replacing one in the home is done often by Home Health Nurses. Keep practicing your skills to keep them active. Does not take but a few seconds and you will feel good about what you do.

[Dirk]

WOW .. .x-ray controlled ng-tubes ... not bad ...

In fact, we don´t do this.
There are some reasons.
first : auscultating is a SAFE procedure. If you can hear the air, it is ok, if not, then not
2nd : we are a little bit carefully with x-ray, because of the harmful aspect of x-ray.
3rd : just let me think about money - what is th eprice for a x-ray, and what is the price for 2 minutes of your time ?

I am sure, there are some hospitals in switzerland, which will do this by x-ray (but I don´t know even one), for me it is a safe method to hear with a stethoscope.

Greetings

Dirk

[EnglishAfternoon]

We don't use the auscultation method here at all as determining NG placement. We rely on x-ray only.

[nursenut23]

thanks for your responses. I was curious.

[Robyn]

Auscultation only...can't say I've ever sent a patient off for an xray post placement.

[aussie-margaret]

Auscultation

litmus paper of anything that comes out of the tube

x ray - only if it was going to be done for another reason

[JanuaryGirl]

Hi, never heard of testing by auscultation, i know that they use to use litmus paper, and xray for fine bore ng tubes, dont know what they do now as i dont work on the wards anymore and we never place them in theatre.

[danidabi]

We auscultate, in class they have mentioned the litmus paper but they just usually ausculate.