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The use of a chest x-ray to confirm position is the expected standard in the UK, with Dr/ physician review and confirmation. Future techniques may include measuring the concentration of enzymes such as trypsin, pepsin, and bilirubin to confirm the correct placement of the NG tube.
On the other hand, if the tube is measured too short, the tip of the NG tube may only reach the esophagus. Due to how close the esophagus is located to the trachea, NG tube placement in the esophagus can be a risk factor for aspiration. [7] As a result, an abdominal X-ray is often performed following NG tube placement to confirm proper ...
The gold standard for checking and confirming NG tube placement is to aspirate some fluid and check the pH level. The pH level of gastric secretions should be between 4-6. A secondary way to confirm placement (no longer the gold standard) is to auscultate using a stethoscope by placing the diaphragm of the stethoscope over the stomach and ...
Inadvertent placement of a nasogastric tube (NGT) into the airway rather than the stomach can lead to complications such as pneumothorax and pneumonia. The use of colorimetric capnography to detect proper placement of a nasogastric tube (NGT) has shown promise, especially in mechanically ventilated patients. With this method, rather than ...
Accordingly, the use of multiple methods for confirmation of correct tube placement is now widely considered to be the standard of care. [34] Such methods include direct visualization as the tip of the tube passes through the glottis, or indirect visualization of the tracheal tube within the trachea using a device such as a bronchoscope.
The tube may be difficult to position, particularly in an unwell patient, and may inadvertently be inserted in the trachea, hence endotracheal intubation before the procedure is strongly advised to secure the airway. The tube is often kept in the refrigerator in the hospital's emergency department, intensive care unit and gastroenterology ward.
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If a nasogastric tube is accidentally placed in the trachea instead of the esophagus, the tube feedings will go into the lungs, which is a life-threatening situation. If the monitor displays typical CO 2 waveforms then placement should be confirmed. [19]