• To re-examine the evidence base that underpins the management of nasogastric tube safety in children
• To recognise the consequences of delayed or missed feeds in children who receive nasogastric tube feeding
• To enhance your understanding of what checks can be used to ensure a nasogastric tube is safe to use
Nasogastric tube feeding is generally considered safe provided a nasogastric aspirate with a pH ≤5.5, which indicates that the end of tube is correctly located in the stomach, can be obtained. When this is not possible, hospital attendance or admission is usually required so that an X-ray can be undertaken to check the tube’s position. This practice is based on an interpretation of the evidence that places undue importance on nasogastric aspirate pH testing before every use of a tube that is already in place, with potential negative consequences for children cared for in the community and their families. Following a re-examination of the evidence base, a revised approach is proposed in this article: when a child has a tube in place, provided its position has been confirmed as correct on initial placement using aspirate pH testing, nurses can use checks other than aspirate pH testing, alongside their clinical judgement, to determine whether it is safe and appropriate to use the tube. This proposed revised approach would reduce delayed or missed administration of fluids, feeds and medicines and enable more children to remain at home.
Nursing Children and Young People. 36, 5, 16-22. doi: 10.7748/ncyp.2024.e1493
Peer reviewThis article has been subject to open peer review and checked for plagiarism using automated software
Correspondencemichael.tatterton@bluebellwood.org
Conflict of interestNone declared
Tatterton M, Mulcahy J, Mankelow J et al (2024) Checking nasogastric tube safety in children cared for in the community: a re-examination of the evidence base. Nursing Children and Young People. doi: 10.7748/ncyp.2024.e1493
Published online: 04 March 2024
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