Paeds Cases · investigations-procedures-and-technology
Verify a nasogastric tube before a feed — OSCE
OSCE clinical-decision and communication station: verifying a nasogastric tube at the bedside before a feed, applying the aspirate pH rule at a threshold of 5.5 or less, recognising and rejecting the deprecated whoosh test, deciding whether to feed or to escalate to radiography, documenting the verification correctly, and explaining the safety check and the Never Event risk to the nurse and the parent in plain language.
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You have eight minutes to verify a four-year-old's nasogastric tube before a feed. Use a structured approach: aspirate and test the pH with the indicator strip, read and state the exact value, decide and defend whether to feed or to escalate, document the verification correctly, and explain the plan and the safety reason to the bedside nurse and to the parent in plain language. The aspirate reads pH 6. [1]
References5ShowHide
- [1]Irving SY, Rempel G, Lyman B Pediatric Nasogastric Tube Placement and Verification: Best Practice Recommendations From the NOVEL Project. Nutr Clin Pract, 2018.PMID 30187517
- [3]Kisting MA, Korcal L, Schutte DL Lose the Whoosh: An Evidence-Based Project to Improve NG Tube Placement Verification in Infants and Children in the Hospital Setting. J Pediatr Nurs, 2019.PMID 30798144
- [4]Metheny NA, Krieger MM, Healey F A review of guidelines to distinguish between gastric and pulmonary placement of nasogastric tubes. Heart Lung, 2019.PMID 30665700
- [6]Metheny NA, Stewart BJ, Smith L pH and concentration of bilirubin in feeding tube aspirates as predictors of tube placement. Nurs Res, 1999.PMID 10414681
- [9]Taylor SJ Feeding tube safety: National guidance ignores the 'elephant in the room'. Int J Risk Saf Med, 2025.PMID 39973429