Important Facts About Intestinal Feeding Tube Placement

Ellett, Marsha L.

doi:10.1097/00001610-200603000-00004

Cited by 26 publications

(33 citation statements)

References 91 publications

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“…Gilbertson [36] demonstrated that a gastric aspirate pH less than 5 is a safe, reliable and practical cut off level in paediatric patients. A pH less than 4 has a predictive value for gastric placement [91,92] while 5 < pH < 6 should be evaluated for bronchial or esophageal placement [37,93] and pH > 6 should be considered as small bowel placement [94]. Perform the successful aspiration of secretions is one of the most important problems for this method of evaluation.…”

Section: Assessment Of Correct Placementmentioning

confidence: 99%

Nasogastric tube insertion in anaesthetized patients: a comprehensive review

Sanaie

Mahmoodpoor

Najafi

2017

Anaesthesiol Intensive Ther

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Nasogastric tubes (NGT) still remain the easiest and the best way for gastrointestinal tract access. There are various indications for the insertion of a nasogastric tube in anaesthetized and critically ill patients. Although many techniques have been introduced to facilitate nasogastric tube insertion using anatomic landmarks and a group of devices, there is no consensus on a standard method. Moreover, there are different methods for the assessment of the correct placement of a nasogastric tube. In addition to these challenges in insertion and assessment methods, there are varieties of major life-threatening and minor complications to be addressed. Thus, selecting the most appropriate approach requires enough knowledge in this area, considering patient condition and clinical factors, as well as the practitioners' sufficient education and experience, along with skill in performance. This is a comprehensive review of the literature evidence on different methods for nasogastric tube insertion, on the assessment of correct placement and the evaluation of complications, in addition to an approach to the effect of education on the quality of routine practice and patients' outcome.

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Section: Assessment Of Correct Placementmentioning

confidence: 99%

Nasogastric tube insertion in anaesthetized patients: a comprehensive review

Sanaie

Mahmoodpoor

Najafi

2017

Anaesthesiol Intensive Ther

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“…7,10,26 Children, as compared with adults, are at increased risk for NG-EAD displacement because of their age (younger children are at higher risk), increased activity, and nonpurposeful movements of limbs or the head and neck. 10,14 In addition, a change in or an altered level of consciousness, vomiting, dysfunctional swallowing, and the type and size of the NG-EAD used put the patient at risk for device misplacement or dislodgement.…”

Section: Misplacement and Dislodgementmentioning

confidence: 99%

“…Last, small-bore feeding tubes often collapse when negative pressure is applied to aspirate gastric contents, making it difficult, if not impossible, to obtain aspirate for visualization and inspection or pH, bilirubin, or enzyme testing. 7 In a 2005 prospective study (n=72) by Ellett et al, 32 a pH upper limit of 5 was used to correctly predict proper placement in 62% of NG-EADs shown by radiography to be properly placed in the stomach. Using the same pH upper limit of 5, 54% of the NG-EADs were improperly placed outside of the stomach.…”

Section: Aspiration Of Gastric Secretionsmentioning

confidence: 99%

“…[5][6][7][8] Halloran et al 9 estimated that more than 1 million NG-EADs are placed annually in adults. However, the number of NG-EADs placed and used in children and the frequency of placement errors is not known.…”

Section: Introductionmentioning

confidence: 99%

“…Although alternative methods exist, abdominal radiographic imaging is the "'gold standard" for verifying NG-EAD placement. 4,6,7,10,15 However, even with radiographs, there may be variation in the interpretation of device location. This variation is due to a lack of consensus on identification of specific anatomic landmarks used to verify the NG-EAD position within the gastric cavity.…”

Section: Introductionmentioning

confidence: 99%

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Nasogastric Tube Placement and Verification in Children: Review of the Current Literature

Irving¹,

Lyman

Northington

et al. 2014

Critical Care Nurse

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Placement of a nasogastric enteral access device (NG-EAD), often referred to as a nasogastric tube, is common practice and largely in the domain of nursing care. Most often an NG-EAD is placed at the bedside without radiographic assistance. Correct initial placement and ongoing location verification are the primary challenges surrounding NG-EAD use and have implications for patient safety. Although considered an innocuous procedure, placement of an NG-EAD carries risk of serious and potentially lethal complications. Despite acknowledgment that an abdominal radiograph is the gold standard, other methods of verifying placement location are widely used and have success rates from 80% to 85%. The long-standing challenges surrounding bedside placement of NG-EADs and a practice alert issued by the Child Health Patient Safety Organization on this issue were the stimuli for the conception of The New Opportunities for Verification of Enteral Tube Location Project sponsored by the American Society for Parenteral and Enteral Nutrition. Its mission is to identify and promote best practices with the potential of technology development that will enable accurate determination of NG-EAD placement for both the inpatient and outpatient pediatric populations. This article presents the challenges of bedside NG-EAD placement and ongoing location verification in children through an overview of the current state of the science. It is important for all health care professionals to be knowledgeable about the current literature, to be vigilant for possible complications, and to avoid complacency with NG-EAD placement and ongoing verification of tube location.

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Choosing wisely: Enteral feeding tube selection, placement, and considerations before and beyond the procedure room

Reddick¹,

Greaves²,

Flaherty³

et al. 2023

Nut in Clin Prac

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When an enteral feeding tube (EFT) is placed, it is not always known how long this nutrition support intervention will be needed. As a result, the type of device the patient originally has placed may not match the function it is required to serve or the lifestyle needs of the patient throughout their enteral nutrition journey. Medicare considers an EFT a prosthetic device, as it is replacing a permanently inoperable or nonfunctioning organ. If we think about an EFT the same way we think about a prosthetic limb, one that needs to be customized to meet all of the patient's functional and lifestyle needs, we can also begin to think beyond the procedure room and carefully consider a variety of factors that impact the patient at home receiving enteral nutrition. Proper fit, function, and style is essential in order for the patient to have a positive relationship with their EFT, contributing to their successful home enteral nutrition experience. Clinicians who care for these patients in any setting and in any capacity would benefit from enhancing their understanding of available EFT options, their design components, and available methods of placement. Many home care and outpatient clinicians adopt the role of patient advocate as it relates to a patient's enteral nutrition journey, and this expanded knowledge could be used to benefit the patient by improving their overall enteral nutrition experience and ultimately their relationship with their "prosthetic."enteral nutrition, feeding tubes, gastrostomy, home nutrition support, jejunostomy ANN'S STORYAnn was diagnosed with gastroparesis at age 18 years. Six years later, at age 24 years, after diet, medication, and lifestyle adjustments, in addition to depending on home parenteral nutrition for several years, the decision was made to place a jejunostomy tube for supplemental home enteral nutrition (EN). A multitude of formula changes and intolerance episodes plagued her EN journey, and finally, at age 29, the decision was made to place a gastric

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Important Facts About Intestinal Feeding Tube Placement

Cited by 26 publications

References 91 publications

Nasogastric tube insertion in anaesthetized patients: a comprehensive review

Nasogastric tube insertion in anaesthetized patients: a comprehensive review

Nasogastric Tube Placement and Verification in Children: Review of the Current Literature

Choosing wisely: Enteral feeding tube selection, placement, and considerations before and beyond the procedure room

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