2.50
Hdl Handle:
http://hdl.handle.net/10755/164245
Category:
Abstract
Type:
Presentation
Title:
Gastric Tube Placement in Young Children
Author(s):
Ellett, Marsha L.; Croffie, Joseph M. B.; Cohen, Mervyn D.
Author Details:
Marsha L. Ellett, DNS, RN, CGRN, Indiana University School of Nursing, Indianapolis, Indiana, USA, email: nacnsorg@nacns.org; Joseph M. B. Croffie, MD; Mervyn D. Cohen, MD, MRCP; Indiana University School of Medicine, Indianapolis, Indiana, USA
Abstract:
Objective: The objective was to test in children potentially better ways to determine the internal position of nasogastric/orogastric (NG/OG) tubes, specifically to 1) identify the range of NG/OG tube placement error rates found in children and 2) identify a superior bedside method of assessing NG/OG tube placement in children. Significance: When tubes are out of place, children can be seriously harmed causing increased morbidity and occasionally even mortality. Design: A comparison-to-gold standard design was used. Methods: A total of 72 hospitalized children < 7 years already having a NG/OG tube in place were recruited. The position of the tube was tested for tube placement error at the bedside by (a) measuring CO2 and (b) measuring tube aspirate for pH and bilirubin. Actual tube position was determined by radiograph within 15 minutes of bedside testing. Findings: Fifteen of the 72 tubes (20.8%) were incorrectly placed on radiograph. Tube aspirate was obtained in adequate amounts for pH measurement in 68/72 (94.4%) of cases. The optimal pH cutoff was 5.15. There was an adequate amount of tube aspirate obtained for bilirubin determination in 62/72 (86.1%) of cases. Values of bilirubin obtained ranged from < .1 to 11.6. Two tubes were found to be in the first part of the duodenum on radiograph. Using the suggested bilirubin cutoff of > 5 mg/dL determined in fasting adults, bilirubin monitoring failed to identify either of these incorrectly placed tubes. No tubes ended in the respiratory tract. Conclusions: The tube placement error rate in children is unacceptably high. The three methods of testing placement need to be studied further in a larger sample under more controlled conditions. Implications: Until further research can be done, pH testing using the suggested adult cutoff of < 5 to predict stomach placement in children and obtaining an abdominal radiograph when either no aspirate is obtained or the pH is > 5 is recommended. Clinical nurse specialists can use this evidence to change the procedure for NG/OG tube placement testing in their facilities.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2004
Conference Name:
2004 NACNS Conference, Renaissance in CNS Practice: Transforming Nursing in the 21st Century
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
San Antonio, Texas, USA
Description:
Conference theme: Renaissance in CNS Practice: Transforming Nursing in the 21st Century, held on March 11 to 13, 2004 in San Antonio, Texas, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleGastric Tube Placement in Young Childrenen_GB
dc.contributor.authorEllett, Marsha L.en_US
dc.contributor.authorCroffie, Joseph M. B.en_US
dc.contributor.authorCohen, Mervyn D.en_US
dc.author.detailsMarsha L. Ellett, DNS, RN, CGRN, Indiana University School of Nursing, Indianapolis, Indiana, USA, email: nacnsorg@nacns.org; Joseph M. B. Croffie, MD; Mervyn D. Cohen, MD, MRCP; Indiana University School of Medicine, Indianapolis, Indiana, USAen_US
dc.identifier.urihttp://hdl.handle.net/10755/164245-
dc.description.abstractObjective: The objective was to test in children potentially better ways to determine the internal position of nasogastric/orogastric (NG/OG) tubes, specifically to 1) identify the range of NG/OG tube placement error rates found in children and 2) identify a superior bedside method of assessing NG/OG tube placement in children. Significance: When tubes are out of place, children can be seriously harmed causing increased morbidity and occasionally even mortality. Design: A comparison-to-gold standard design was used. Methods: A total of 72 hospitalized children < 7 years already having a NG/OG tube in place were recruited. The position of the tube was tested for tube placement error at the bedside by (a) measuring CO2 and (b) measuring tube aspirate for pH and bilirubin. Actual tube position was determined by radiograph within 15 minutes of bedside testing. Findings: Fifteen of the 72 tubes (20.8%) were incorrectly placed on radiograph. Tube aspirate was obtained in adequate amounts for pH measurement in 68/72 (94.4%) of cases. The optimal pH cutoff was 5.15. There was an adequate amount of tube aspirate obtained for bilirubin determination in 62/72 (86.1%) of cases. Values of bilirubin obtained ranged from < .1 to 11.6. Two tubes were found to be in the first part of the duodenum on radiograph. Using the suggested bilirubin cutoff of > 5 mg/dL determined in fasting adults, bilirubin monitoring failed to identify either of these incorrectly placed tubes. No tubes ended in the respiratory tract. Conclusions: The tube placement error rate in children is unacceptably high. The three methods of testing placement need to be studied further in a larger sample under more controlled conditions. Implications: Until further research can be done, pH testing using the suggested adult cutoff of < 5 to predict stomach placement in children and obtaining an abdominal radiograph when either no aspirate is obtained or the pH is > 5 is recommended. Clinical nurse specialists can use this evidence to change the procedure for NG/OG tube placement testing in their facilities.en_GB
dc.date.available2011-10-27T11:44:44Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:44:44Z-
dc.conference.date2004en_US
dc.conference.name2004 NACNS Conference, Renaissance in CNS Practice: Transforming Nursing in the 21st Centuryen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationSan Antonio, Texas, USAen_US
dc.descriptionConference theme: Renaissance in CNS Practice: Transforming Nursing in the 21st Century, held on March 11 to 13, 2004 in San Antonio, Texas, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_US
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