CXR confirmation of nasogastric tube placement

How to improve radiographers’ confidence in recognising misplaced NG tubes to enhance patient safety

Nasogastric (NG) tubes are primarily used for feeding, with thousands inserted daily without incident1.

However, misplacement of an NG tube into the lungs can lead to life-threatening complications or even death if it is then used for feeding2. Therefore, verifying correct tube placement before use is critical. The first-line method for confirming gastric placement is by testing the NG tube aspirate. The pH of gastric aspirate (stomach contents) typically ranges from 0 to 5, indicating an acidic environment. This acidity helps confirm correct placement of an NG tube in the stomach. Misplacement of an NG tube can lead to serious complications. While pneumothorax is a rare outcome, more common risks include aspiration pneumonia and respiratory distress. If not promptly identified and managed, these can progress to a pulmonary abscess due to infection.

Figure 1
Correct placement of nasogastric tube

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