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Clinical Nursing Research, Vol. 14, No. 3, 238-252 (2005)
DOI: 10.1177/1054773805275121

Gastric Tube Placement in Young Children

Marsha L. Cirgin Ellett

Indiana University School of Nursing

Joseph M.B. Croffie

Riley Hospital for Children, Indiana University School of Medicine

Mervyn D. Cohen

Riley Hospital for Children, Indiana University School of Medicine

Susan M. Perkins

Indiana University School of Medicine

In this study, the internal position of a nasogastric/orogastric tube was determined in 72 children, prior to an abdominal radiograph, by measuring CO2 and pH and bilirubin of tube aspirate. Fifteen of the 72 tubes (20.8%) were incorrectly placed on radiograph. Using the suggested adult cutoff of pH 5, pH of aspirate correctly predicted misplacement outside the stomach in 7/28 (25%) of children and correctly predicted correct placement in the stomach in 34 of 40 children (85%). Using the suggested adult cutoff of bilirubin ≥ 5 mg/dL, bilirubin monitoring failed to identify either of two incorrectly placed tubes. In this study, using an algorithm of assuming stomach placement if the pH of aspirate is ≤ 5 and obtaining an abdominal radiograph when either no aspirate is obtained or the pH is >5 would have resulted in 92% accuracy. Alternatively, obtaining an abdominal radiograph would result in nearly 100% accuracy.

Key Words: nasogastric tubes • children • feeding tubes • enteral tubes


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