What is the gold standard method for initial verification of correct placement of a newly inserted small-bore nasogastric (NG) feeding tube before initiating enteral feeding?
Answer and explanation
Correct answer: B. Abdominal radiograph (X-ray) confirming tip position in the stomach
- Step 1: Enteral tube misplacement into the tracheobronchial tree can lead to fatal aspiration or pneumothorax if formula is infused.
- Step 2: An abdominal/chest radiograph visualizing the entire course and tip of the radiopaque tube in the stomach below the diaphragm is the definitive gold standard before initial use.
Answer
Abdominal radiograph (X-ray) confirming tip position in the stomach.
Why not the others: Auscultation of an air bolus ('whoosh test') is notoriously unreliable and can transmit sounds from respiratory airways; absence of coughing does not rule out lung placement; litmus paper is unstandardized.
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