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NG Tube Placement pH Confirmation — FRCA Final MCQ

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EasyAnaesthetic Equipment & SafetyNG Tube Placement pH ConfirmationFRCA Final

A 65-year-old man on the ICU has an orogastric tube for enteral nutrition. The nurse reports that the NG aspirate pH is 6.5 using pH paper. According to NPSA guidance, can enteral feeding commence?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — No – pH must be ≤5.5 to confirm gastric placement

NPSA (2011) and NHS England patient safety alerts specify that nasogastric/orogastric tube placement must be confirmed before feeding. The first-line confirmation method is pH testing of aspirate: a pH of ≤5.5 confirms gastric placement. A pH of 6-8 is indeterminate and may indicate respiratory, oesophageal, or intestinal placement. If pH is >5.5 or no aspirate is obtained, a CXR must be obtained to confirm position. NEVER use auscultation ('whoosh test') to confirm placement – this is unreliable and has caused deaths.

Reference: NHS England – 2016 – Patient safety alert: NG tube placement; NPSA – 2011 – NG tube safety