PMID: 15632757Jan 6, 2005

What is known about methods of correctly placing gastric tubes in adults and children

Gastroenterology Nursing : the Official Journal of the Society of Gastroenterology Nurses and Associates
Marsha L Cirgin Ellett

Abstract

An abdominal radiograph is considered the "gold standard" for determining the position of flexible small-bore nasogastric/orogastric tubes. However, placement must be checked frequently while a tube is in place, and the summative radiation risk of multiple radiographs, as well as their expense, make the development of adequate bedside placement-locating methods imperative. Several methods of detecting tube placement have been investigated in adults, including: aspirating gastric contents and measuring the pH, bilirubin, pepsin, and trypsin levels; examining the visual characteristics of aspirate; placing the proximal end of the tube under water and observing for bubbles in synchrony with expirations; measuring the carbon dioxide level at the proximal end of the nasogastric/orogastric tube; auscultation for a gurgling sound over the epigastrium or left upper quadrant of the abdomen; and measuring the length from the nose/mouth to the proximal end of the tube. Many researchers have already concluded simple auscultation is not a reliable method to assess tube position because injection of air into the tracheobronchial tree or into the pleural space can produce a sound indistinguishable from that produced by injecting air into the ...Continue Reading

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