How to avoid mistakes when performing intubation and assessing placement
Insertion of a nasogastric tube is a common procedure mainly undertaken by nurses, final year medical students, and junior doctors. Although it is often thought of as a straightforward procedure, insertion can sometimes be difficult. It is also not without its risks, not least incorrect positioning of the tube. The National Patient Safety Agency (NPSA) reported 11 deaths where nasogastric tubes had been misplaced in 2005.1 Junior doctors are often responsible for checking the position of the tube.
Nasogastric tubes are commonly used for artificial feeding, gastric decompression, and administering medicines or radiographic contrast. The decision to insert a nasogastric tube for feeding purposes often involves doctors, dietitians, and speech and language therapists. The patient’s cognitive state, family members’ wishes, and advanced directives should also be considered when making the decision to insertion a nasogastric tube.
There are several relative contraindications for insertion of a nasogastric tube—that is, making the