Best Practices for Confirming OG Tube Placement
Don Marcello
Correctly placing an Orogastric (OG) tube is a vital component of proper OG tube feeding. Despite that, OG tube misplacements are all too common and can cause some significant complications when they occur. The best way to avoid those complications is to learn the best practice for confirming OG tube placement and how to perform it. By testing OG tube placement regularly, you can ensure safe use throughout the feeding period.
Best Practice Method for Confirming OG Tube Placement
There are multiple ways that you can confirm the placement of an OG tube. However, not all methods are equally desirable. Overall, the best method for testing and confirming the placement of an OG tube is to perform a pH test. Performing a pH test will provide you with results almost instantaneously. Additionally, pH tests are accurate and easy to perform in many locations without the need for any significant equipment or machinery.
How to Confirm OG Tube Placement Using a pH Test
Knowing that the use of a pH testing kit is the best method for confirming OG tube placement is not enough. Instead, you should also take time to learn the correct process for performing OG tube placement confirmation. The next few sections will outline the steps you should take.
Preparing to Confirm OG Tube Placement
The first step when confirming OG tube placement is to assemble all of the equipment you’ll need throughout the process. Fortunately, you’ll need only a few items, which we have listed below:
- Gloves
- An irrigation syringe
- A pH testing kit
Along with collecting the correct items, you’ll also want to make sure that they are sterile before you use them. As a final preparation step, wash your hand thoroughly and then put on your pair of gloves.
Collecting Stomach Fluid
In order to test the placement of an OG tube using a pH test, you’ll need to collect fluid from the person’s stomach. Connect the irrigation syringe to the end of the OG tube, and after the syringe is connected, pull the syringe’s plunger until the syringe’s barrel begins to fill with fluid from the stomach.
Testing the pH
Now that you have extracted stomach fluid via the OG tube, it is time to test its pH. The results of the pH test will give a clear indication of whether or not the tube has proper placement. Many pH testing kits provide strips to test pH. However, there are newer and better tools that you can use, including pH indicators that connect directly to your syringe and provide a result almost immediately.
If you test the pH of the stomach fluid you collected and it is at or below 4.5, that indicates that the OG tube has the correct placement and is likely safe to use to administer nutrients or medication. A pH level that is above 4.5 indicates that the OG tube is not properly placed, and you’ll need to adjust it before use.
Monitoring Other Factors
The person who placed the OG tube initially likely left a mark on the tube at the point where it exits the person’s mouth. Noting the presence of this mark at the beginning and end of the confirmation process helps ensure that the tube is properly placed and has not shifted. You should also monitor the person for any discomfort or other signs that indicate the OG tube’s placement is off.
Other Methods for Confirming OG Tube Placement
Although using pH is typically the easiest and most effective way to confirm the placement of an OG tube, we should also mention that there are other approaches, some of which are more viable than others.
For example, one of the most common ways to test the placement of an OG tube is by using X-ray. X-ray provides a clear visual image of the OG tube’s position, but it comes with some downsides. Mainly, confirming tube placement with X-ray may require a visit to a different medical facility, takes a longer amount of time, and also exposes the body to radiation. By contrast, none of these cons are present when using a pH test to confirm OG tube placement.
You may also hear about some older methods of testing tube placement, such as auscultation, also known as the ‘woosh test’. The woosh test involves forcing air down into the OG tube and was a more common practice during times when X-ray and pH tests were not as readily available. But despite its historical use, the efficacy of the woosh test is far from proven and is not an advisable method compared to more reliable means like pH tests or X-rays.
When to Confirm OG Tube Placement
Confirming OG tube placement is not something you’ll need to do once or just a few times. Instead, it is a practice that you’ll need to follow repeatedly throughout the period during which the person is using the OG tube for feeding or medication. Here is a quick list of the times when you should certainly confirm OG tube placement:
- Immediately after placing an OG tube
- Before performing an OG tube feeding
- After replacing or adjusting an OG tube
Remember that these are not the only times when it is appropriate to confirm the placement of an OG tube. It is wise and advisable to perform OG tube placement tests any time you suspect the OG tube has shifted out of place or when you simply want to reconfirm correct placement.
Why is Testing OG Tube Placement Important?
Testing the placement of an OG tube before use is a vital safety requirement any time you or someone you are assisting needs to use an OG tube. The reason for that is that OG tube misplacement can lead to complications, some of which are mild and some of which are life-threatening.
Confirming OG tube placement on a regular basis is the best way to reduce the risk of misplacement. It is also the best practice method for ensuring that you are using your OG tube in the safest and most effective manner.
