Use of capnometry to verify feeding tube placement

Abstract

Capnometry is a safe method for verifying proper feeding tube placement. The first chest roentgeno-gram can be safely eliminated. With this method, less time and money will be expended in feeding tube placement, making capnometry an efficacious new method.

Methods Used by Critical Care Nurses to Verify Feeding Tube Placement in Clinical Practice

“…24,31,36 The location of the feeding tube should be verified every 4 hours once feeding has been established to assess for change in tube position. 2,12,17 Methods for ongoing verification may include monitoring the length of the externally marked feeding tube from the exit site (nare or lip) 12,37,38 or monitoring gastric residual volumes for changes.…”

Nasogastric tube insertion in anaesthetized patients: a comprehensive review

“…Ultrasonography [30] Ph indicator [36,37] Stridor [47] Pulmonary aspiration [50] Sort maneuver [22,23] Airway scope [31] Electromagnetic device [38] Pneumothorax [51] Nelaton [32] Chemical assessment of aspirates (Ph, trypsin, bilirubin, CO 2 and pepsin) [39,40] Perforation of lamina cribrosa [52] Tube length End tidal CO 2 monitoring [41] Retropharyngeal abcess [47] Fluroscopy [42] Stricture formation Endoscopy [42] Aortoesophageal fistula [52] Manometer [43,44] Nasogastric tube syndrome [53,54] (TEE) probe insertion (See video at: http://atlasofscience. org/nasogastric-tube-insertion-the-simple-yet-impossible/ accessed 11 Nov 2016).…”

“…Araujo-Preza et al [39] showed that end tidal CO 2 monitoring is a safe, easy and cost effective method for confirming the correct placement of a NGT and one may omit radiography with the use of capnometry. Burns et al [40] compared capnographic evaluation with colorimetric CO 2 detection for correct NGT placement and concluded that colorimetric device is as accurate as capnography in this regard.…”

Colorimetric carbon dioxide detector to determine accidental tracheal feeding tube placement

“…2 Complications include pneumothorax, atelectasis, pleural effusion, bronchopleural fistula, hydrothorax, empyema, mediastinitis, pneumonitis, esophageal perforation and pneumonia. 3 Auscultation of air in the stomach has been classically used to confirm placement, but air infused into the pleural space can just as easily be heard over the upper abdomen. 4 This method, as well as other tests that confirm placement after the tube is fully advanced takes place when the tube may already have perforated the bronchus.…”