Our Meridian Innovation Exchange has published a call for solutions to consistently confirm the placement of an nasogastric tube.
Nasogastric (NG) tubes sit in a patient’s stomach and are used for administering supplementary feeds and medicines, when a patient is unable to take them orally. They are life saving devices.
When inserting an NG tube, it is possible to pass it into a patient’s respiratory tract instead of their stomach. It is also possible for an NG tube, which is passed correctly into a patient’s stomach, to migrate from the stomach into the respiratory tract. This can happen when a patient vomits or coughs excessively.
When using NG tubes, nurses aspirate the NG tube using a syringe they attach to it. Any fluid they obtain is then pH tested. If that pH test = <5.5 then national guidelines state this is likely to be acidic stomach contents and therefore the NG tube is safe to use. If the pH result is >6.0 then it is possible the NG tube is in the respiratory tract.
There have been many serious incidents across the UK where patients have died / been seriously harmed after NG tubes have been used whilst they are incorrectly placed in a patients respiratory tract. This has been the subject of National Patient Safety Agency (NPSA) alerts and there are guidelines from the National Institute for Health and Clinical Excellence (NICE) that govern how NG tube placement should be confirmed.
Despite NPSA alerts and NICE guidelines, these serious incidents are still occurring. The reasons for this are:
This problem affects all patients requiring feeding via NG tubes, neonates, children, young people, adults, patients with learning difficulties and patients with mental health problems.
What is needed?
We need a hand held device that is able to consistently confirm the placement of an NG tube. This device needs to:
All innovations will be reviewed by Karl Emms Lead Nurse for Patient Safety at the Birmingham Children's Hospital. He is looking forward to reviewing any ideas or innovations and is keen to give feedback and co collaborate along with his clinical colleagues.