Q: Is any evidence available to support practices for verifying nasogastric tube (NGT) placement in critically ill pediatric patients?

A: Beth Lyman, RN, MSN, CNSC, replies: Yes, there is evidence to guide this practice; there is even an international work group addressing this issue.

The American Society for Parenteral and Enteral Nutrition has a task force called the NOVEL (New Opportunities for Verification of Enteral tube Location) project. This group of physicians and nurses from Australia, Canada, and the United States is working to promote best practice for verification of NGT placement.

Twenty-four percent of hospitalized pediatric patients require an NGT. Of those patients, approximately 18% are in a pediatric intensive care unit.1  A 1999 pediatric study by Ellett and Beckstrand2  documented that 22% to 44% of NGTs were misplaced when verified by abdominal radiography. A study by Quandt et al3  documented that the odds...

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