The first line test for determining the site of a nasogastric feeding tube is pH testing of aspirate from the tube. If the pH is between 1 and 5.5 feeding may be commenced.
If an aspirate cannot be obtained (various manoeuvres can be attempted) or the pH is> 5.5 then a chest x ray should be performed to determine positioning.
If the pH reading is between 5.5 and 6 it is recommended that a second independent reading is made to confirm.
According to National Patient Safety Association guidance on the use of nasogastric feeding tubes feeding cannot be commenced if aspirate is obtained with a pH ≥6.
The guidance advises that aspirate appearance, litmus paper testing and 'whoosh' testing should not be used in determining nasogastric tube placement as they are not reliable.
If an aspirate cannot be obtained (various manoeuvres can be attempted) or the pH is> 5.5 then a chest x ray should be performed to determine positioning.
If the pH reading is between 5.5 and 6 it is recommended that a second independent reading is made to confirm.
According to National Patient Safety Association guidance on the use of nasogastric feeding tubes feeding cannot be commenced if aspirate is obtained with a pH ≥6.
The guidance advises that aspirate appearance, litmus paper testing and 'whoosh' testing should not be used in determining nasogastric tube placement as they are not reliable.
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