scholarly journals Feeding tube placement: auscultatory method and x-ray agreement

2015 ◽  
Vol 36 (4) ◽  
pp. 98-103 ◽  
Author(s):  
Mariur Gomes Beghetto ◽  
Franciele Anziliero ◽  
Dória Migotto Leães ◽  
Elza Daniel de Mello

Objective: to evaluate the correlation between the auscultation test and X-ray when detecting the position of an enteral feeding tube. Methods: cross-sectional study in an intensive care unit in southern Brazil, in 2011. Clinical nurse and nurse researcher performed auscultation test recording the impressions regarding the placement of an enteral feeding tube in 80 patients. A doctor evaluated the X-ray. Kappa coefficient and PABAK reviewed the agreements. Results: The X-ray showed that 70% of the enteral tubes were in the stomach, 27.4% in the duodenum, 1.3% in the esophagus, and 1.3% in the right lung. There was a weak correlation between clinical nurses and nurse researchers (PABAK = 0.054; P = 0.103), clinical nurses and X-rays (PABAK = 0.188; P = 0.111) and nurse researchers and X-rays (PABAK = 0.128; P = 0.107) . The auscultation test did not detect two risk conditions, enteral feeding tube in the esophagus and the bronchus. Conclusion: the auscultation test showed little agreement with the X-ray on the enteral feeding tube location.

2021 ◽  
Vol 16 ◽  
Author(s):  
Marina Massae Toma ◽  
Gabriel de Freitas Santana ◽  
Tales Rubens de Nadai ◽  
Fabiana Rossi Varallo ◽  
Jhohann Richard de Lima Benzi ◽  
...  

Background: Extemporaneous compounding (EC) involves preparation of a therapeutic product to a specific-patient need. However, there is a potential relation between this procedure and the occurrence of health incidents (HI). The use of triggers tool increases HI identification. Objective: This study assessed the performance of EC as trigger to detect potentially health incidents arising from this procedure. Method: A one-month observational and cross-sectional study was performed in internal medicine ward and intensive care unit of medium-sized hospital. Data collection was carried out in 5 stages: all triggered patients with dysphagia or enteral feeding tube with prescription of EC were included; it was observed all EC executed in standardized drugs prescribed; the procedure was compared with the hospital guide and scientific literature; HI monitoring and their evaluation using WHO and NCC MERP algorithms; a search for pharmaceutical alternatives (PA) that would avoid the observed EC. Results: 197 patients were recruited. Almost half of them were triggered by EC from 84 standardized drugs. 48 patients met inclusion criteria. It was identified 28 adverse drug reactions, 01 therapeutic ineffectiveness and 29 medication errors. EC as trigger tool showed a PPV value of 0.38. Finally, only 24 drugs have PA available in the market, that could avoid one third of all observed EC. Conclusion: It was possible to detect potentially HI in one of two patients with enteral feeding tube using EC as trigger tool. The use of EC as a trigger tool contributes to identify potentially HI arising from drugs, which have not gotten pharmaceutical alternatives to be administered via enteral feeding tube.


Author(s):  
Danyara BATISTA ◽  
Paula M. OLIVEIRA-LEMOS

Objective: To identify the most prescribed drugs by enteral feeding tube in a public hospital and to a guideline for safe medication preparation and administration via enteral feeding tubes. Methods: A cross-sectional study with analysis of the daily prescriptions of patients exclusively using an enteral catheter in intensive care units and inpatients of the medical clinic specialty, in which descriptive statistics were used to identify the prevalence of medication use by tube. In a second step, a protocol was developed for the situation in which oral medications are prescribed to patients with a tube in the digestive tract. Results: A total of 1.810 medications prescribed by enteral feeding tube, of these 1.810, 291 (16%) were prescribed in liquid pharmaceutical form (suspension, solution, syrup) e 1.519 (84%) were prescribed in solid pharmaceutical form (tablets, capsule). 52 medications were selected for the protocol, and 14 of them (26.9%) with the recommendation of not crushing and administering via enteral feeding tube. Conclusion: Our results highlights the performance of clinical pharmacist in monitoring patients with enteral feeding tubes and guidance of multi-professional team. The protocol elaboration will guide for preparation and administration medication through the enteral feeding tube, reducing possible adverse events and ensuring the safety and efficacy of drug therapy.  


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sheeja Perumbil Pathrose ◽  
Kaye Spence ◽  
Christine Taylor ◽  
Kim Psalia ◽  
Virginia Schmied ◽  
...  

2021 ◽  
Author(s):  
Julius Muchui Thambura ◽  
Jeanette G.E du Plessis ◽  
Cheryl M E McCrindle ◽  
Tanita Cronje

Abstract Introduction Anecdotal evidence suggests that medical professionals in trauma units are requesting additional regional images using conventional x-ray systems, even after trauma patients have undergone full-body Lodox scans. Patients are then exposed to additional radiation, additional waiting times and an increased medical bill. This study aimed at investigating the extent to which Lodox systems were used in trauma units (n=28) in South Africa. Method In this descriptive cross-sectional study, the researcher invited one radiographer from the 28 hospitals in South Africa that use Lodox systems. Radiographers who were most experienced in using the Lodox system completed an online questionnaire. Results Twenty (71.43% n=20) out of twenty-eight radiographers responded. Most hospitals (90%, n=18) were referring patients for additional conventional x-ray images. Radiographers indicated that conventional x-rays were requested for the chest (27.80%, 10/36), the abdomen (16.67%, 6/36), the spine (13.89%, 5/36) and the extremities and skull (19.44%, 7/36). Additionally, radiographers reported using Lodox to perform procedures and examinations usually performed on conventional x-ray systems when conventional x-ray systems were not operational. Conclusion Currently, it is not clear if the use of conventional x-ray imaging following Lodox is necessary, but the results suggest that the practice is commonplace, with healthcare workers in most hospitals (90%, n=18) requesting additional x-ray imaging. The researcher thus recommends that an imaging protocol for Lodox imaging systems should be developed to guide the referral of the patients for further imaging.


1987 ◽  
Vol 32 (10) ◽  
pp. 1212-1213
Author(s):  
Ann M. Kools ◽  
Linda S. Snyder ◽  
Oliver W. Cass

Author(s):  
Inaê A. SPEZIA ◽  
Filipe C. MATHEUS

Objective: This study aims to evaluate medication prescriptions to be used by a feeding tube in an emergency unit, identify and classify the problems with the prescriptions and suggest interventions, done by a pharmacist, when necessary. Also aims to develop a guide with information about administering medication through the feeding tube in order to help the health care team. Methods: the study is characterized as a quantitative cross-sectional study, with data collected during March to September of 2019 at an adult emergency unit, a total of 47 prescriptions were analyzed by a pharmacist and 138 drugs were prescripted to be administered through a feeding tube. Results: A total of 18.8% of those medications presented some restriction to be administered by the feeding tube. The most common problems observed were the loss or reduction of therapeutic effect present in 61,6% of the cases, followed by drug-food interactions with 30.8%. About the pharmaceutical intervention more performed was requesting to change the pharmaceutical form (36%), followed by orientation about stop the enteral feeding (30.2%). To the elaboration of the guide for the health care team, 181 medications standardized at the hospital were analyzed, of that 33.1% presented some restriction to administer by feeding tube and only 35% presented another pharmaceutical form for substitution. Conclusion: it was possible to note the importance of pharmaceutical evaluation of prescriptions to identify errors and prevent future problems assuring the patient’s safety. The guide elaboration sought to assist and optimize the process of medication administration by feeding tube guaranteeing the safety and effectiveness of pharmacotherapy.


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