Effectiveness of using an electromagnetic tube placement device for placement of bedside small bowel feeding tubes in a regional burn center

Abstract

Early and adequate nutritional support is crucial in the care of burn patients. There have been described in literature many different methods for and technology to aid in the placement of small bowel feeding tubes that are used to provide the needed enteral nutrition. The purpose of this study was to determine if using an electromagnetic tube placement device (ETPD) was an effective way to play blind (without aid of fluoroscopy and endoscopy) bedside small bowel feeding tubes in a regional burn center. After IRB approval, quality improvement (QI) data that had been collected on burn patients who required small bowel feeding tube placement at a regional burn center before (control) and after (trial) the implementation of using an ETPD device for placement of small bowel feeding tubes, July-December 1006 and all of 2007, were levied. There were 55 patients with 148 feeding tube placements in the study, 36 feeding tube placements were in the pre-ETPD (control) group and 112 feeding tube placements were in the post-ETPD (trial) group. The age of the patients ranged from 20-78, the BMI’s ranged from 15.82-51.96, and 16 patients had an inhalation injury. In the pre-ETPD (control group) there were 25 blind placements with a success rate of 24%. The 11 fluoroscopy placements with a success rate of 81.8% were significantly more successful (p=0.002) than the blind placement. In the post-ETPD (trial) group there were 40 blind placements with a success rate of 22.5%. In the post-ETPD (trial) group there were 40 blind placements with a success rate of 22.5%. In the post-ETPD (trial) group the 18 fluoroscopy placements with a success rate of 77.8% and 54 placements with the ETPD with a success rate of 85.2% were both significantly more successful than the blind placement method (p=<0.001). Based on the results of this study, the use of an ETPD device was effective in aiding the placement of bedside small bowel feeding tubes and can also help prevent the complication of lung misplacement.