AJCC
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

American Journal of Critical Care. 2007;16: 544-549
Copyright © 2007 by the American Association of Critical-Care Nurses.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Respond to This Article
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Elpern, E. H.
Right arrow Articles by Gurka, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Elpern, E. H.
Right arrow Articles by Gurka, D.

CE Article

Capnometry and Air Insufflation for Assessing Initial Placement of Gastric Tubes

By Ellen H. Elpern, RN, APN, CCNS, Kathryn Killeen, RN, APN, CCNS, Erlinda Talla, RN, BSN, Gabriel Perez, RN, BSN and David Gurka, MD, PhD. Ellen H. Elpern and Kathryn Killeen are advanced practice nurses, Erlinda Talla and Gabriel Perez are senior clinical nurses, and David Gurka is an attending physician in adult critical care at Rush University Medical Center, Chicago, Illinois.

Corresponding author: Ellen H. Elpern, RN, APN, 1725 W Harrison, Ste 054, Chicago, IL 60612 (e-mail: Ellen_H_Elpern{at}rush.edu).

Background Nurses are often responsible for placement of large-bore gastric tubes. Tube misplacement into the lungs is a potential complication with serious sequelae. The reliability of common bedside methods for differentiating between pulmonary and gastric placement has not been acceptable.

Objective To compare the accuracy of capnometry (colorimetric indicator of end-tidal carbon dioxide) and air insufflation/auscultation with the accuracy of radiography in detecting the location of gastric tubes.

Methods A prospective convenience sample of insertions of Salem sump gastric tubes was studied. Tubes were inserted by nurses according to the unit’s standard procedure, and air insufflation/auscultation, capnometry, and radiography were used to detect the position of the tubes. Results obtained with each of the methods were compared.

Results A total of 91 tube placements were studied in 69 patients. No radiographically documented instances of lung placement occurred. Capnometry incorrectly indicated 15 of 91 gastric placements (16%) as placements in the lung. Air insufflation/auscultation incorrectly indicated 5 of 91 gastric placements (5%) as placements in the lung.

Conclusions Neither air insufflation nor capnometry is a fail-safe method for determining placement of gastric tubes. Radiography remains the preferred method.

Notice to CE enrollees:A closed-book, multiple-choice examination following this article tests your understanding of the following objectives:
  1. Describe different methods for determining placement of gastric tubes.
  2. Assess the accuracy of capnometry, air insufflation, and radiography in determining the correct placement of gastric tubes.
  3. Understand the limitations of both capnometry and air insufflation for assessing placement of gastric tubes.
To read this article and take the CE test online, visit www.ajcconline.org and click "CE Articles in This Issue." No CE test fee for AACN members.




This article has been cited by other articles:


Home page
 Am J Crit CareHome page
A. M. Bourgault and M. A. Halm
Feeding Tube Placement in Adults: Safe Verification Method For Blindly Inserted Tubes
Am. J. Crit. Care., January 1, 2009; 18(1): 73 - 76.
[Full Text] [PDF]

Home page
 Crit Care NurseHome page
C. A. Rauen, M. Chulay, E. Bridges, K. M. Vollman, and R. Arbour
Seven Evidence-Based Practice Habits: Putting Some Sacred Cows Out to Pasture
Crit. Care Nurse, April 1, 2008; 28(2): 98 - 123.
[Full Text] [PDF]

Home page
 Am J Crit CareHome page
L. Bell and B. Cox
Determining the Correct Placement of Gastric Tubes
Am. J. Crit. Care., November 1, 2007; 16(6): 551 - 551.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2007 by the American Association of Critical-Care Nurses.