title: [Is a clinical positional control for nasogastric tubes good enough? A prospective study of 43 patients].
abstract: OBJECTIVE
  Nasoenteric tubes are usually introduced blindly by nursing staff, i.e. without visual or radiological control. A prospective study was undertaken to determine how often such blind procedure results in potentially dangerous tube placement and how often such faulty positioning remains undetected in a standardised clinical check.
  
  
  METHODS
  43 patients (23 men, 20 women; age 24-90 years) requiring the introduction by nursing staff of a nasoenteric tube were studied, 12 in an intensive care unit (seven intubated) and 31 in an ordinary ward. At most 24 hours after the customary check of the tube's position by the nursing staff (air injection with epigastric auscultation), specially experienced medical and nursing personnel determined and recorded the tube's placement in a standardised manner. Subsequent radiological examination documented the position.
  
  
  RESULTS
  All 43 tubes lay in the gastrointestinal tract. Only one tube was in a potentially dangerous position in the lower end of the oesophagus, as had already been diagnosed by the examiners. Of four other tubes which were not optimally placed (three in the region of the cardia, one in the duodenum) three were found to be "not correctly placed" by the clinical check, and one was detected only radiologically.
  
  
  CONCLUSIONS
  Clinical control of a nasoenteric tube's position suffices in most instances. Checking the position further by an experienced person adds to safety. The study's findings suggest that radiological control can be safely limited to cases in which there was a problem in positioning the tube or the clinical control was unclear.
authors.affiliation: Medizinische Abteilung Anna-Seiler-Haus, Inselspital, Bern, Schweiz.
authors.forename: S
authors.initials: S
authors.lastname: Christen
authors.forename: T
authors.initials: T
authors.lastname: Hess
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004064:Digestive System / Q000000981:diagnostic imaging; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000379:methods* / Q000451:nursing / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography