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    Radiology responsibilities post NPSA guidelines for nasogastric tube insertion: A single centre review

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    Publication date
    2015-02
    Author
    Snaith, Beverly
    Flintham, K.
    Keyword
    Nasogastric tube; NG tube; Radiography; Radiology; Reporting; Exposure
    Peer-Reviewed
    Yes
    
    Metadata
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    Abstract
    There are well-recognised complications associated with malposition of nasogastric (NG) tubes. In 2011 the UK National Patient Safety Agency (NPSA) published an alert regarding their insertion and position confirmation. This alert also identified the expected radiology standards for both image acquisition and reporting. This was a retrospective review of referrals over a six-month period within a multi-site NHS Trust. A consecutive sampling approach was used and radiology reports where the text included the terms “NG tube”, “nasogastric” or “feeding” were included. Data were collected from the radiology information system and NG tube visibility and image quality were confirmed by two independent reviewers. 1137 examinations demonstrated an NG tube, of which 68.3% were performed to check tube position. There was statistically significant correlation between lower radiation exposure and non-visualisation (Fishers exact test, p < 0.001). The number of examinations with higher exposure index (EI) in the NG check cohort suggests that the radiographer increased the exposure to improve visualization (x2 = 2.846; 95% CI; p = 0.046), although the utility of this is unproven. Malplaced tubes were demonstrated either in the respiratory tract (1.8%) or proximal gastrointestinal tract (8.6%) as a result of insufficient length introduced. The prompt acquisition and reporting of radiographs is essential to reduce the risk of NG tube complications. Respiratory tract misplacement rates were in line with the published literature, but this study does raise concern regarding the number of tubes located in the proximal GI tract. Radiology's responsibility in accurate and effective reporting of medical interventions is significant.
    URI
    http://hdl.handle.net/10454/15693
    Version
    No full-text in the repository
    Citation
    Snaith B and Flintham K (2015) Radiology responsibilities post NPSA guidelines for nasogastric tube insertion: A single centre review. Radiography. 21(1): 11-15.
    Link to publisher’s version
    https://doi.org/10.1016/j.radi.2014.05.004
    Type
    Article
    Collections
    Health Studies Publications

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