Visual characteristics of aspirates from feeding tubes as a method for predicting tube location

A sample of 880 feeding tube aspirates were classified as being primarily clear or cloudy and as having one of six colors. Gastric aspirates were most frequently cloudy and green, tan or off-white, or bloody or brown. Intestinal fluids were primarily clear and yellow to bile-colored. In the absence of blood, pleural fluid was usually pale yellow and serous, and tracheobronchial secretions were usually tan or off-white mucus. However, respiratory aspirates often contained blood and therefore failed to have the expected characteristics of respiratory fluid. Staff nurses were shown photographs of a sample of 106 aspirates and asked to predict tube position. Their ability to identify 50 gastric aspirates improved significantly after reading a list of suggested characteristics of feeding tube aspirates (81.33% to 90.47%, p < .0001). Similarly, their ability to identify 50 intestinal aspirates improved from 64.07% to 71.53% after reading the list of criteria. However, nurses were often unable to identify respiratory aspirates; the accuracy of their predictions decreased after reading the list of suggested characteristics (from 56.67% to 46.11%). The appearance of aspirates is often helpful in distinguishing between gastric and intestinal placement, but is of little value in ruling out respiratory placement.