What is the best method for confirming the proper placement of a nasogastric (NG) tube in an unconscious patient?

Obtaining radiographic confirmation is the most reliable method for confirming the proper placement of a nasogastric (NG) tube in an unconscious patient. This approach is essential because it provides a definitive visual assessment of the tube’s location within the gastrointestinal tract, ensuring it is in the stomach and not misplaced into the lungs or other areas. This is particularly important in unconscious patients, where other evaluation methods may lack accuracy due to unresponsive or altered physiological states.

While observing visible gastric secretions may suggest that the tube is in the stomach, it is not foolproof. Gastric contents can sometimes be misinterpreted, especially if the tube has moved or if there is an associated condition affecting gastric secretions.

Assessing for abdominal distension can indicate problems related to tube placement or function but does not confirm placement. Furthermore, checking pH levels of aspirate can be useful and often is used in clinical practice; however, it is not as definitive as radiographic confirmation. A pH test can provide supporting evidence that the tube is in the stomach, but factors such as medications and diet can affect the pH levels, making this method less reliable compared to radiographic imaging.