• Guideline - ngt insertion
  Link:www.nrls.npsa.nhs.uk/EasySiteWeb/getresource.axd?AssetID=60002&type=full&servicetype=Attachment
  
• Trust actions
• Named lead for implementing change
• Policies reviewed to ensure steps compliant
• Ongoing audit undertaken
• Review purchasing so all are radio-opaque
• Remove all litmus paper and ensure new paper is CE marked pH graded.
• HCP
• Consider if the ngt is appropriate
• Placement deferred if skills to confirm placement are inadequate
• Ngt used should have markings and be radio-opaque
• Ngt not flushed prior or during insertion until tip is confirmed
• pH used as 1st line, with pH between 1-5.5 as safe range
• X-ray only if no Aspirate or equivocal pH test
• X-ray request must specify for ngt position
• Aspirate obtained
• Yes
• pH test
• Between 1-5.5 then use
• pH not between 1-5.5
• X-ray
• No
• Try turning
  Inject 10-20ml air
  Wait 30 mins
  Advance tube 10cm
  Give mouth care
• Aspirate
• No aspirate
• X-ray