Confirming Proper Placement of NG Tube

Always use more than one method to ensure proper tube placement; never rely on just one method.

For small-bore nasointestinal tubes (may collapse under pressure when aspirating), or if incorrect placement is otherwise suspected, confirm placement by x-ray.

Observation

• Verify marking on tube is at Pt’s nostril.
• Compare length of exposed tube to initial length documented in Pt’s chart.

Aspiration

• Aspirate gastric contents using a 20-mL syringe.
• Gastric aspirate should appear green with particulate matter or brown if blood is present.

Measurement of pH

• Dip litmus paper into gastric aspirate.
• A pH of 1–3 (<5) suggests placement in stomach.

Auscultation

Method is controversial and is not used in some institutions.

• Inject 20 mL of air into tube while auscultating abdomen.
• A loud gurgle of air suggests placement in stomach.