A practical point is that 17% of polyurethane tubes required injection of water to permit guide-wire manipulation to facilitate tube placement to an adequate depth within the stomach. NPSA guidelines ban water injection prior to placement because sterile water and NaCl solution is acidic and can falsely indicate gastric pH. However, gastric pH can be safely differentiated from that of water injected down the tube by using tap-water checked as pH>6.0. Water injection prior to insertion facilitates guide-wire manipulation whereas inability to manipulate the guide-wire to attain deeper placement or placing tubes equivalent to the distance from xiphisternum to ear to nose, as per the NPSA (2011) guideline, leaves many tubes barely within the stomach (Taylor et al, unpublished observations). It would require minimal slippage to leave the port(s) within the oesophagus and risk aspiration.