Share Facebook
Crohn's Disease Forum » Treatment » Enteral Nutrition & TPN » How often do you check placement?


10-26-2011, 03:28 PM   #1
izzi'smom
Senior Member
 
izzi'smom's Avatar
 
Join Date: May 2011
Location: New York

My Support Groups:
How often do you check placement?

We just received our pump and the nurse was surprised that we received no instructions on ng tube placement...anyone have to check placement periodically? TIA!
__________________
Angie, mom to Izzi,10 Crohn's Colitis 1/11 prednisone, entyvio since 2015 Tried: Tacrolimus, Bactrim, simponi, Levsin, Prevacid, Prednisilone, Humira, Remicade, EN via ng, vancomycin, Pentasa, carafate, Sulfasalazine, Cortifoam enemas, dietary changes, fish oil, VSL#3.
10-26-2011, 03:49 PM   #2
DustyKat
Super Moderator
 
DustyKat's Avatar
 
Join Date: May 2010
Location: New South Wales, Australia
Hey Angie,

From a nursing point of view I check the placement before each feed or before connecting to a pump. I imagine it would be the same at home.

Dusty. xxx
__________________
Mum of 2 kids with Crohn's.
10-26-2011, 03:55 PM   #3
Misty-Eyed
Forum Monitor
 
Misty-Eyed's Avatar
 
Join Date: Feb 2010
Location: United Kingdom

My Support Groups:
I used to have a syringe and litmus paper when I had my ng tube. I used to syringe some stomach fluid out and then put it on the litmus paper. If the paper turned colour then it was in the right place. Saying that, I could take mine out by myself even though I was only 12 at the time. I used to draw a line on the tube so I knew how far to put the tube down. Then you can always monitor how far the tube is from where the mark was. To be honest though, if the tube is always taped to the face, then you wouldn't expect it to move!
__________________
Michelle

'You can't change the past but you can ruin the present by worrying about the future.'

Diagnosed with Crohn's colitis aged 9, 1992.

Panproctocolectomy and terminal end ileostomy October 2011.
10-26-2011, 03:57 PM   #4
Tesscorm
Moderator
 
Tesscorm's Avatar
 
Join Date: Jun 2011
Location: Ontario

My Support Groups:
We were instructed to check each evening - however, Stephen was inserting/removing every day; after 5 months, now we rarely check.

We were taught two ways to check - once the tube is in place, attach a small syringe (if you need, I can check size at home???) and quickly blow air into the ng tube. You do this while listening through a stethoscope and, if correctly placed, you should hear a faint 'pop' approx. 1-2 fingers below ribcage. We usually couldn't hear a pop, guess you need a trained ear! And you have to blow the air in quickly or there won't even be a pop. But, while we couldn't hear it, Stephen said he could sometimes 'feel' the pop.

The second method was still with the syringe hooked up to the NG tube, you should be able to draw out a little bit of the stomach fluid. If you are able to extract fluid, my understanding was that it was in the right location. This was an easier method than trying to hear a pop. (Heads up - do not do this immediately after Izzi has a red popsicle or red coloured juice!!! LOL)
10-26-2011, 03:58 PM   #5
DustyKat
Super Moderator
 
DustyKat's Avatar
 
Join Date: May 2010
Location: New South Wales, Australia
Unfortunately, even with the tube taped it can move due to things like coughing, vomiting, sneezing, etc.

Dusty.
10-26-2011, 04:06 PM   #6
Tesscorm
Moderator
 
Tesscorm's Avatar
 
Join Date: Jun 2011
Location: Ontario

My Support Groups:
Hi Dusty,

Stephen does as Michelle mentioned - he has the measurement marked on the tube. Other than growing in height, is there a reason he would still need to regularly check the placement (or marking on the tube)?

Given his age (17), would he not 'feel' if the placement was incorrect?

Thanks
10-26-2011, 04:11 PM   #7
Misty-Eyed
Forum Monitor
 
Misty-Eyed's Avatar
 
Join Date: Feb 2010
Location: United Kingdom

My Support Groups:
Lol is it even possible to vomit without bringing the tube back up, Dusty? If so, I wish I'd learnt that trick! Also the sneezing took me right back to memories of taking the tube out with all kinds of nasal delights stuck on the tube!

I really wish I could stop being so gross on this forum. Siggghhh. I'll blame the pain killers.
10-26-2011, 06:39 PM   #8
DustyKat
Super Moderator
 
DustyKat's Avatar
 
Join Date: May 2010
Location: New South Wales, Australia
Oh man Michelle, you would be surprised at what some people can do!

@Tess, to be honest I would think he would know if the tube had gone into his lungs and no doubt he has the technique down pat. If you were to ask at the hospital though they would probably say to check daily and it is standard practice to check for placement everytime the tube is inserted.
I am often dealing with people in acute situations or that don't have a gag reflex so it is critical in these situations and also with children.

Dusty. xxx
10-26-2011, 07:46 PM   #9
izzi'smom
Senior Member
 
izzi'smom's Avatar
 
Join Date: May 2011
Location: New York

My Support Groups:
OMG Michelle, you've got me rolling over here. Izzi vomited up her first feed...and I don't *think* the tube moved (now you've all got me panicked that I've put 4 cans into her lungs today!) Funny she was just picking her nose (I know, gross, but she's 4, and she does it) and it got me wondering, umm, if/how to remove nasal...ummm drainage that isn't liquid shall we say? I just let her pick.
OK, enough. Sorry.
I have a syringe and a stethoscope, so I can try that in the am. I have to shop for some duoderm soon so I'll look for litmus paper too. A lot of fluid is probably unlikely in the lungs but I am sure it is better to test the ph to be certain.

We are doing (5-7)daytime feedings, so maybe I'll check in the am and once in the pm. Thanks all, and thanks Michelle for the laughs!
10-27-2011, 12:57 PM   #10
izzi'smom
Senior Member
 
izzi'smom's Avatar
 
Join Date: May 2011
Location: New York

My Support Groups:
Well, unable to aspirate (I think because it's so small it gets gummed up...always takes a few minutes for the flush to begin flowing also)but was able to figure out what noise I was supposed to be hearing :thumbsup: Our nurse actually apologized for the chaos the day she got her ng tube (after I told her I am still upset over it, plus the fact that I didn't get any info re caring for it) and admitted it was only the second one they've done in the office.
Anyway, feeling much better now that I know I am not pumping liquid into the wrong place...thanks, all!
10-27-2011, 02:47 PM   #11
Misty-Eyed
Forum Monitor
 
Misty-Eyed's Avatar
 
Join Date: Feb 2010
Location: United Kingdom

My Support Groups:
Haha sorry, I didn't mean to panick you! I'm sure she would of noticed 4 cans her her lungs! I'm jealous she could vomit and keep it down! I used to vomit SO much in the middle of the night and the tube used to come right out my mouth.. Weirdest feeling having something go in your nose and out of your mouth!

And believe me, having nasal deposits as I'll call them, on the tube is just way too tempting not to pick them off!

Glad you have something to go on now and feel better on it. I hope it goes ok for Izzi too
Reply

Crohn's Disease Forum » Treatment » Enteral Nutrition & TPN » How often do you check placement?
Thread Tools


All times are GMT -5. The time now is 12:42 AM.
Copyright 2006-2017 Crohnsforum.com