MATERIALS:Hydrion Ph Paper Ph 1-11 in Original Packaging with Ph Indicator

MANUAL: Point of Care / POLICY No. 123.0
EFFECTIVE: 06/01/2017 / SUBJECT: pH for Gastric Fluid, Waived
REVIEWED: See Point of Care
Media Lab / DIVISION: POC Laboratory / PAGE 1 of 2
REVISED: See Point of Care
Media Lab / ISSUING DEPT:
Point of Care / DISTRIBUTION:
Point of Care
APPROVED LABORATORY DIRECTOR:
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PRINCIPLE:The pH test is used as a qualitative guide in Nasogastric (NG) tube placement. A pH test is based on the principle that certain dyes change color with changes in hydrogen ion concentration. These are measured on a scale of 1-14 with 7 being neutral pH, values above 7 being increasingly basic and values below 7 increasingly acidic.

Gastric aspirates have decidedly acidic pH values, preferably 4 or less, compared with intestinal aspirates that are usually greater than 4, or respiratory secretions, which are usually greater than 5.5.There are no known reports of pulmonary aspirates at or below 5.5 pH1. A cut-off of a pH < 5 is recommended to predict gastric placement.

MATERIALS:Hydrion pH paper pH 1-11 in original packaging with pH indicator.

Assayed buffers with pH 4, 5 and 6.

SPECIMEN:Gastric fluid pulled from a Nasogastric (NG) Tube.

QUALITY CONTROL:Kalispell Regional Medical Center Lab personnel test each new lot of HydrionpH paper for quality against two known standards before release for use. The known testing standards may be at a pH of 4.0, 5.0 or 6.0.

PROCEDURE:1.Make sure the patient is properly identified according to established protocol.

2.Collect aspirate specimen during NG tube placement according to nursing policy.

3.After checking the expiration date of the Hydrion pH paper tear off approximately 2 inches. Return rest of paper to provided container.

4.Apply one drop of sample to the pH paper or dip pH paper into aspirated fluid.

5.Determine pH of sample by visual comparison of test area to pH color chart found on the provided container. This comparison must be done immediately. If visual determination of sample pH is <5 (red or dark orange color change) proper placement of NG tube is confirmed.

REPORTABLE RANGE:

pH is resulted as a number ex. 1, 2, 3 etc. Acceptable placement is determined by a pH <5 or unacceptable placement by a pH of >5.

RESULT METHOD:Notation in interventions with test documentation in Meditech.

REFERENCE RANGE:<5.0 pH of aspirated fluid confirms correct placement of NG Tube.

LIMITATIONS:This test is read visually and requires color differentiation. It should not be interpreted by staff determined to have any form of color blindness. Any pH paper that appears mottled, off color or stored outside of its provided container should be discarded. Ph paper should not be used after its expiration date.

REFERENCES:National Patient Safety Agency,Reducing the harm caused by misplaced nasogastric feeding tubes. Interim advice for healthcare staff – February 2005.1

Micro Essential Laboratories Inc. Package insert 2013.

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/POC/Policies/pH Gastric fluid