Background
Nasogastric (NG) tubes are used for both enteral nutrition and/
or decompression of the stomach or small bowel. However there
are well-recognised complications associated with malposition
during insertion, the most severe being inadvertent placement in
the respiratory tract with its associated risk.1 In 2011 the UK National
Patient Safety Agency (NPSA) published an alert regarding
NG tubes highlighting the issue of incorrect placement and risk
from subsequent patient feeding.2 This alert confirmed the feeding
of a patient through an incorrectly sited NG tube to be a ‘never
event’. The alert stated that pH testing of NG tube aspirate must be
the first line investigation to ensure position of the tube tip within
the stomach, with subsequent chest radiograph where the finding
is inconclusive or aspirate not acquired. Radiographs are the gold
standard in the confirmation of tube and line position,2e4 however
despite recognition of need for prompt examination3,5 little heed
has previously been played to the importance of responsive
interpretation, in particular radiology reporting. For the first time,
the NPSA alert identified the standards expected from radiology
departments both in terms of image acquisition and reporting.
Background
Nasogastric (NG) tubes are used for both enteral nutrition and/
or decompression of the stomach or small bowel. However there
are well-recognised complications associated with malposition
during insertion, the most severe being inadvertent placement in
the respiratory tract with its associated risk.1 In 2011 the UK National
Patient Safety Agency (NPSA) published an alert regarding
NG tubes highlighting the issue of incorrect placement and risk
from subsequent patient feeding.2 This alert confirmed the feeding
of a patient through an incorrectly sited NG tube to be a ‘never
event’. The alert stated that pH testing of NG tube aspirate must be
the first line investigation to ensure position of the tube tip within
the stomach, with subsequent chest radiograph where the finding
is inconclusive or aspirate not acquired. Radiographs are the gold
standard in the confirmation of tube and line position,2e4 however
despite recognition of need for prompt examination3,5 little heed
has previously been played to the importance of responsive
interpretation, in particular radiology reporting. For the first time,
the NPSA alert identified the standards expected from radiology
departments both in terms of image acquisition and reporting.
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