Irving Sharon Y, Lyman Beth, Northington LaDonna, Bartlett Jacqueline A, Kemper Carol
Sharon Y. Irving is a pediatric critical care nurse practitioner at The Children's Hospital of Philadelphia and an assistant professor at the University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania. She is the AACN liaison for the New Opportunities for Verification of Enteral Tube Location (NOVEL) project sponsored by the American Society of Parenteral and Enteral Nutrition (A.S.P.E.N.).Beth Lyman is a senior program coordinator for the nutrition support team at Children's Mercy Hospital in Kansas City, Missouri, and is the chair of the NOVEL project sponsored by A.S.P.E.N.LaDonna Northington is director of the traditional undergraduate program at the University of Mississippi, School of Nursing, in Jackson, and a member of the Society of Pediatric Nursing.Jacqueline A. Bartlett is director of evidence-based practice at Children's Mercy Hospital in Kansas City, Missouri.Carol Kemper is vice president of quality and safety at Children's Mercy Hospital in Kansas City, Missouri and a steering committee member for the Children Health Patient Safety Organization/Children's Hospital Association.
Crit Care Nurse. 2014 Jun;34(3):67-78. doi: 10.4037/ccn2014606. Epub 2014 Apr 15.
Placement of a nasogastric enteral access device (NG-EAD), often referred to as a nasogastric tube, is common practice and largely in the domain of nursing care. Most often an NG-EAD is placed at the bedside without radiographic assistance. Correct initial placement and ongoing location verification are the primary challenges surrounding NG-EAD use and have implications for patient safety. Although considered an innocuous procedure, placement of an NG-EAD carries risk of serious and potentially lethal complications. Despite acknowledgment that an abdominal radiograph is the gold standard, other methods of verifying placement location are widely used and have success rates from 80% to 85%. The long-standing challenges surrounding bedside placement of NG-EADs and a practice alert issued by the Child Health Patient Safety Organization on this issue were the stimuli for the conception of The New Opportunities for Verification of Enteral Tube Location Project sponsored by the American Society for Parenteral and Enteral Nutrition. Its mission is to identify and promote best practices with the potential of technology development that will enable accurate determination of NG-EAD placement for both the inpatient and outpatient pediatric populations. This article presents the challenges of bedside NG-EAD placement and ongoing location verification in children through an overview of the current state of the science. It is important for all health care professionals to be knowledgeable about the current literature, to be vigilant for possible complications, and to avoid complacency with NG-EAD placement and ongoing verification of tube location.
放置鼻胃管肠内通路装置（NG-EAD，通常称为鼻胃管）是常见的操作，很大程度上属于护理范畴。大多数情况下，NG-EAD是在床边放置，无需影像学辅助。正确的初始放置和持续的位置验证是围绕NG-EAD使用的主要挑战，对患者安全有影响。尽管放置NG-EAD被认为是一种无害的操作，但仍存在严重且可能致命并发症的风险。尽管公认腹部X线片是金标准，但其他验证放置位置的方法也被广泛使用，成功率在80%至85%之间。围绕床边放置NG-EAD的长期挑战以及儿童健康患者安全组织就此问题发布的实践警示，是美国肠外与肠内营养学会发起的肠内导管位置验证新机遇项目构思的刺激因素。其任务是识别并推广具有技术开发潜力的最佳实践，从而能够准确确定住院和门诊儿科患者的NG-EAD放置位置。本文通过概述当前科学现状，介绍了儿童床边放置NG-EAD及持续位置验证的挑战。所有医疗保健专业人员了解当前文献、警惕可能的并发症并避免对NG-EAD放置及导管位置的持续验证自满是很重要的。
