A survey of gastric tube practices in level II and level III nurseries

Gastric tube placement practices were identified by a telephone survey of 113 Level II and Level III nurseries in five states (Indiana, Kentucky, Michigan, Ohio, and Pennsylvania). The purpose was to examine current practice and the rationale for practice with fragile preterm infants. Twenty-one percent of the nurseries inserted only orogastric (OG) tubes, 13% used only nasogastric (NG) tubes, and 66% used both NG and OG tubes. Of those that placed an NG or OG tube, 50% did so continuously, 5% placed it intermittently, and 45% placed the tube both continuously and intermittently, for different reasons. The average time interval to change a tube was 47.81 hr (±36.37), and the range was 8 to 168 hr. To calculate the length of tube insertion, 98% of nurseries measured from nose or mouth to earlobe then to the xiphoid process. To validate tube placement, 82% used an auscultation technique, and 60% had rules about replacing gastric aspirates. These findings indicate a great variability of practices in gastric tube placements and a reliance on tradition of practitioners working with preterm infants. The findings point to the need for further research on the most efficient practices and the importance of using research findings in nurseries.