Bedside placement of small-bowel feeding tubes in the intensive care unit

Early enteral feeding is beneficial to critically ill patients, although it is often a challenge to accomplish. When required, placing feeding tubes into the small bowel can be costly and difficult to carry out in a timely manner, often requiring fluoroscopic or endoscopic guidance. We implemented a modified protocol that enabled nurses to place feeding tubes at the bedside without fluoroscopy. This technique has resulted in timely placement, with initiation of enteral feeding in less than 24 hours. Ninety-five percent of the attempted placements were successfully completed at the bedside. Transport of patients was avoided, and no specialized equipment was required. Therefore, greater satisfaction for patients with less risk was possible, and caregivers benefited as well.