Temporary Enteral Access Placement Verification in Pediatric Patients: A Continuing Conundrum

There is a serious clinical challenge for pediatric clinicians who order or place temporary enteral access devices, commonly referred to as nasogastric (NG) or orogastric (OG) tubes. Placement verification methods that are commonly used for adults, such as an abdominal radiograph, are avoided by or not available to pediatric clinicians. Use of bedside techniques to verify placement have also failed to be 100% reliable. This session will address the current status of bedside techniques to verify placement of NG or OG tubes in infants and children with special emphasis on those in the PICU or NICU. We will make recommendations for best practice based on current literature and will summarize the results of a point prevalence study conducted by the New Opportunities for Verification of Enteral Tube Location (NOVEL) project. Using data from that study as a platform, speakers will address the wide variation among the 63 participating organizations in how they verify placement of these tubes. We will also share information about the population who has one of these tubes. Until technology is available to assure accurate assessment of NG and OG location, standardization of practice is a priority for the organizations participating in the NOVEL project.

Learning Objectives:

• Discuss the commonly used methods to verify placement of a temporary enteral access device.
• Analyze the unique characteristics of the PICU and NICU population that make verification of temporary enteral access device placement a challenge.
• Summarize how the results of the prevalence study might guide future research.