Nasogastric tube placement

Introduction and objectives

Nasogastric (NG) tubes are mainly used for feeding, with thousands inserted daily without incidence². However, there is a risk of life-threatening difficulties or death if the NG tube is misplaced in the lungs and used for feeding³. Correct tube placement must always be checked before use. NG tube aspirate is the first-line test to confirm gastric placement. If aspirate cannot be obtained, or if the pH value is above 5.5, a chest X-ray examination (CXR) should be undertaken to confirm NG tube position^{2, 3}.

Following reports of 21 deaths and 79 cases of harm owing to feeding into the lungs through misplaced NG tubes, a safety alert was issued⁴. Despite further safety alerts these ‘never events’ are still occurring, mainly because of the misinterpretation of CXRs³. Radiographers are well placed to...