Comparing Bedside Methods of Determining Placement of Gastric Tubes in Children

Insertion of a gastric tube (nasogastric [NG] or orogastric [OG]) is a common medical intervention in children for a wide range of clinical indications, including delivery of enteral nutrition, administration of medications, decompression of the stomach following intestinal obstruction or surgery, irrigation of the stomach, and performance of diagnostic procedures (Phillips, 2006). When the gastrointestinal (GI) tract is intact and the need for assisted feeding is expected to be short-term, feeding by an NG/OG tube is preferred over feeding through a gastrostomy tube (Kirby, Delegge, & Fleming, 1995). Small-bore NG/OG tubes are usually used for enteral nutrition because they are made of soft polyurethane that remain flexible when exposed to gastric acid; thus, patient discomfort is reduced (Sriram, Jayanthi, Lakshmi, & George, 1997). Small-bore NG/OG tubes also reduce the risk of aspiration because the smaller diameter does not affect the competency of the lower esophageal sphincter as much as large-bore tubes (Phillips, 2006; Sriram et al., 1997); however, small-bore tubes are known to be misplaced on insertion and to displace during use (Ellett & Beckstrand, 1999; Ellett, Maahs, & Forsee, 1998; Metheny, 1988; Williams & Leslie, 2004).