Research Dietitian, Department of Nutrition and Dietetics, Southmead Hospital Bristol and Member of BAPEN's NG-Special Interest Group.
Consultant in Intensive Care Medicine, Intensive Care Unit, Southmead Hospital Bristol.
Br J Nurs. 2020 Nov 26;29(21):1277-1281. doi: 10.12968/bjon.2020.29.21.1277.
Electromagnetic (EM) guided enteral tube placement may reduce lung misplacement to almost zero in expert centres, but more than 60 undetected misplacements had occurred by 2016 resulting in major morbidity or death.
Determine the accuracy of manufacturer guidance in trace interpretation against what is referred to as the 'GI flexure system'.
The authors prospectively observed the accuracy of the 'GI flexure system' of trace interpretation against manufacturer guidance in primary nasointestinal (NI) tube placements.
Contrary to manufacturer guidance, 33% of traces deviated >5 cm from the sagittal midline and 26.5% were oesophageal when entering the lower left quadrant, incorrectly indicating lung and gastric placement, respectively. Conversely, the GI flexure system identified ≥99.4% of GI traces when they reached the gastric body flexure; 100% at the superior duodenal flexure. All lung misplacements were identified by the absence of GI flexures.
Current manufacturer guidance should be updated to the GI flexure system of interpretation.
确定制造商指导中关于“胃-肠（GI）弯曲系统”的解读与实际的吻合程度。
作者前瞻性地观察了“胃-肠弯曲系统”在解读轨迹线时对制造商指导的准确性。
与制造商的指导意见相反，33%的轨迹线偏离矢状中线超过 5 厘米，26.5%在进入左下象限时为食管，分别错误地提示了肺部和胃部的位置。相反，当 GI 轨迹线到达胃体弯曲时，GI 弯曲系统能够识别出 99.4%以上的 GI 轨迹线；在十二指肠上段弯曲时，能够识别出 100%的 GI 轨迹线。所有的肺部位置错误都可以通过没有胃-肠弯曲来识别。
当前制造商的指导意见应更新为 GI 弯曲系统的解读。
