Gastric Tube Placement Verification CPG Synopsis-Gastric Tube Placement Verification CPG Synopsis

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The Clinical Practice Guideline (CPG) focuses on the verification of gastric tube placement in the emergency department setting immediately after insertion. The standard of care requires confirmation of accurate placement to prevent complications. Radiographic examination, specifically X-ray or CT scan, is considered the gold standard for confirmation. However, bedside methods are often used due to cost, time, and radiation exposure concerns. Auscultation, a common bedside method, has been found to be inaccurate but is still widely practiced.<br /><br />The CPG evaluates various bedside gastric tube placement verification methods as alternatives to radiography. The following options/interventions and their level of recommendation are discussed:<br /><br />1. pH testing of gastric tube aspirates: There is moderate evidence to support its use as part of multiple-method bedside verification.<br /><br />2. Bedside ultrasound guidance: Supported by the literature, although the level of evidence is moderate.<br /><br />3. Carbon dioxide detection: Some evidence supports its use for bedside verification.<br /><br />4. Gastric lipase testing: If commercially available, it can be used for bedside verification based on limited evidence.<br /><br />5. Auscultation: Using it as a single verification method is unreliable.<br /><br />6. Transillumination and magnetic detection: Requires equipment, and further study is needed for its sole use as a bedside verification method.<br /><br />The level of recommendation is classified as follows:<br /><br />- Level A: High, based on consistent and good quality evidence.<br />- Level B: Moderate, with some minor inconsistencies in evidence.<br />- Level C: Weak, with limited or low-quality evidence.<br />- N/R: Not recommended based on current evidence.<br />- I/E: Insufficient evidence to make a recommendation.<br />- N/E: No evidence to make a recommendation.<br /><br />The ENA's CPGs are evidence-based documents that aim to bridge the gap between practice and available evidence, positively impacting patient care in emergency nursing. Guidelines are created following a systematic review and critical analysis of the literature. The full CPG can be accessed on the ENA website.

Meta Tag

gastric tube CPG

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gastric tube confirmation

gastric tube auscultation

gastric tube aspiration

gastric tube CO2

gastric tube carbon dioxide

gastric tube transillumination

gastric tube magnetic

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Keywords

Clinical Practice Guideline

gastric tube placement

emergency department

verification

radiographic examination

bedside methods

auscultation

pH testing

ultrasound guidance

carbon dioxide detection