RightSpotpH vs Cortrak: Choosing the Right Tube Placement Verification System

Accurate placement of feeding tubes is crucial for patient safety and effective nutrition delivery. Two leading options for tube placement verification are RightSpotpH and Cortrak. This article compares these systems to help healthcare professionals make an informed decision.

Overview of Tube Placement Verification Systems

Feeding tube placement verification systems are essential tools in healthcare settings, ensuring that tubes are correctly positioned before use. This is vital to prevent complications such as aspiration pneumonia, misplaced feeding, or intestinal perforation.

The Importance of Accurate Tube Placement

Misplaced feeding tubes can lead to serious complications, including:

• Aspiration pneumonia
• Pneumothorax
• Intestinal perforation
• Misplaced feeding leading to malnutrition
• Increased healthcare costs due to complications and extended hospital stays

Accurate verification systems are crucial for patient safety and efficient healthcare delivery.

RightSpotpH Indicator

The RightSpotpH Indicator is a device designed by RightBio Metrics to quickly and accurately verify the placement of nasogastric (NG) and orogastric (OG) tubes by assessing gastric pH. It offers a reliable method to ensure correct tube placement without the need for frequent hospital visits or X-rays.

Cortrak 2 Enteral Access System

The Cortrak 2 Enteral Access System (EAS) is designed to help guide the placement of nasoenteral feeding tubes and confirm their correct position. It uses electromagnetic sensing technology to track the path of the feeding tube during placement.

Key Features Comparison

Here’s a comparison of the key features of RightSpotpH and Cortrak:

Feature	RightSpotpH	Cortrak
Technology	pH measurement	Electromagnetic tracking
Tube Types	NG/OG tubes	Nasoenteral tubes
Confirmation Method	Gastric pH assessment	Real-time tube tracking
X-ray Requirement	No	May still be required
Portability	Highly portable	Less portable (equipment-based)
Cost	Lower initial cost	Higher initial cost
Ongoing Costs	Disposable indicators	Proprietary feeding tubes
Ease of Use	Simple, minimal training	Requires more extensive training

Detailed Analysis

Accuracy and Reliability

RightSpotpH offers a straightforward method of verifying tube placement by assessing gastric pH. This technique is based on the well-established difference in pH between the stomach and the respiratory tract, providing a reliable indication of correct placement. Studies have shown that pH testing has a sensitivity of 91% and specificity of 100% for detecting gastric placement. Cortrak uses electromagnetic tracking to visualize the path of the tube during placement. While this can provide real-time guidance, it may still require X-ray confirmation in some cases, as noted in the NHS England Patient Safety Alert. The accuracy of Cortrak has been reported to be between 95-98% in clinical studies.

Safety and Regulatory Compliance

Both RightSpotpH and Cortrak comply with current safety regulations. However, it’s important to note that in 2022, the FDA issued a Class I recall for Cortrak 2 due to reports of injuries and patient deaths related to misplacement of nasogastric feeding tubes. As a result, Avanos Medical, the manufacturer of Cortrak 2, was required to update the device’s labeling and instructions for use. The recall does not mean Cortrak 2 is off the market. Instead, it emphasizes the importance of proper training and adherence to updated guidelines when using the device. Healthcare professionals should be aware of these updates and ensure they are following the most current protocols. RightSpotpH, being a pH-based system, has not been subject to similar recalls. Its simplicity and reliance on well-established physiological principles contribute to its safety profile.

User-Friendliness and Training Requirements

The RightSpotpH Indicator is designed for simplicity and ease of use, making it ideal for various healthcare settings, including homecare. Even without extensive medical training, caregivers can use it confidently to confirm tube placement. Training typically takes less than an hour, and the device can be used effectively after a brief orientation. Cortrak requires more specialized training and equipment. It involves a portable monitor unit, specific feeding tubes with transmitters, and a receiver unit. This complexity may limit its use to more specialized healthcare settings. Training for Cortrak typically takes several hours and may require periodic refresher courses to maintain proficiency.

Cost-Effectiveness and Time Savings

RightSpotpH offers a cost-effective solution for tube verification. It reduces the need for X-rays and potential complications from misplacement, potentially leading to significant cost savings. A study at a 500-bed hospital found that implementing RightSpotpH led to a 73% reduction in X-ray usage for tube verification, resulting in an annual cost saving of approximately $215,000. Cortrak has a higher initial cost and requires the use of proprietary feeding tubes, which are more expensive than standard tubes. While it may reduce the need for some X-rays, the overall cost-effectiveness compared to simpler methods is not clear from the available information. However, in complex cases where difficult tube placement is anticipated, Cortrak’s real-time guidance may lead to time savings and reduced patient discomfort.

Versatility and Portability

RightSpotpH is highly portable and can be used in various settings, from hospitals to homecare environments. This versatility makes it particularly valuable for patients requiring long-term tube feeding at home. The device weighs less than 100 grams and can easily fit in a pocket or small bag. Cortrak, while offering advanced features, is less portable due to its equipment requirements. It’s primarily designed for use in hospital settings where the full system can be set up and operated by trained personnel. The system includes a monitor and receiver unit, which limits its mobility compared to RightSpotpH.

Real-World Application and Challenges

In practice, both systems face unique challenges: RightSpotpH:

• Requires aspiration of gastric contents, which may be difficult in some patients
• pH results can be affected by medications that alter gastric acidity
• Not suitable for verifying post-pyloric tube placement

Cortrak:

• Electromagnetic interference can affect readings in some hospital environments
• Requires maintenance of equipment and staff training to ensure accuracy
• Higher cost may limit availability in some healthcare settings

Making the Right Choice

Selecting between RightSpotpH and Cortrak depends on specific healthcare needs:

• For a simple, cost-effective solution suitable for various settings: RightSpotpH
• For advanced real-time tracking in specialized hospital environments: Cortrak

Consider factors like the primary use environment, staff training requirements, and long-term cost implications when making your decision. Always ensure that your chosen system aligns with current safety regulations and hospital protocols. RightBio Metrics offers expert consultation on the RightSpotpH Indicator. To learn more about how this innovative pH-based verification system can enhance patient safety and streamline tube placement procedures in your healthcare setting, contact RightBio Metrics today for a personalized demonstration and discussion of your specific needs.

FAQs

How does the RightSpotpH Indicator work? 

The RightSpotpH Indicator works by assessing the pH of gastric aspirate. It provides a quick and accurate way to verify that the feeding tube is correctly placed in the stomach, rather than in the respiratory tract.

Is X-ray confirmation still necessary with these systems? 

While RightSpotpH can often eliminate the need for X-ray confirmation, Cortrak may still require X-rays in some cases. Always follow your facility’s protocols for tube placement verification.

Can these systems be used in pediatric patients? 

RightSpotpH is designed for use in various patient populations, including pediatrics. Cortrak has been used in pediatric settings, but may require more specialized training for this population.

How do these systems contribute to patient safety? 

Both systems aim to reduce the risk of complications from misplaced feeding tubes. RightSpotpH does this through quick and reliable pH testing, while Cortrak provides real-time visualization of tube placement.

What ongoing costs are associated with each system? 

RightSpotpH requires the purchase of disposable pH indicators for each use. Cortrak requires the use of specific, more expensive feeding tubes and may have additional maintenance costs for the electronic system.

How has the 2022 FDA recall affected the use of Cortrak 2?

The recall has led to updated labeling and instructions for use of Cortrak 2. Healthcare facilities using Cortrak 2 should ensure they are following the most current guidelines and have implemented any required training updates.

What are the implications of the different technologies used by RightSpotpH and Cortrak? 

RightSpotpH’s pH-based technology is simpler and less prone to technical issues, but it’s limited to confirming gastric placement. Cortrak’s electromagnetic tracking offers real-time guidance but may be affected by electromagnetic interference and requires more technical expertise.

How do these systems fit into broader hospital protocols for patient safety?

Both systems can be integrated into comprehensive patient safety protocols. They should be used in conjunction with other safety measures, such as proper hand hygiene, patient identification procedures, and regular staff training on tube placement and verification techniques.