Safe nasogastric tube placement

An audit to establish compliance with national standards for confirming safe nasogastric tube placement

Nasogastric tubes (NGTs) are used to administer food or medicine directly to the patient's stomach via a tube inserted into the nasal cavity. Diagnostic imaging is not routinely used during insertion, which introduces the possibility of complications such as misplacement into the respiratory tract1. This may not be immediately apparent and can result in serious or fatal consequences, so placement must be checked after initial insertion and before every use2.

Although chest X-rays (CXRs) are widely regarded as the gold standard for NGT visualisation, checking the pH of gastric aspirate is preferred to avoid delays and unnecessary radiation exposure. A CXR is requested only when aspirate is unavailable or if the pH is outside of the safe range of 1 to 5.53. Radiographic technique should ensure that the whole of the NGT is visible, with the X-ray beam centred...

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