What is the best method to assess safe placement of an NG tube?

Obtaining radiographic confirmation is considered the best method to assess safe placement of a nasogastric (NG) tube because it provides a clear and definitive visual assessment of the tube's position within the gastrointestinal tract. Radiographic imaging can confirm that the tube lies in the stomach or an appropriate portion of the intestines, ensuring that it is not in the lungs, which would pose a significant risk for aspiration and respiratory complications.

While clinical assessments of tube length can provide some guidance, they are not always reliable due to variations in human anatomy. Checking gastric residuals and measuring pH of gastric contents can indicate whether the tube is in the stomach, but they are not definitive methods for confirming proper placement and could lead to false reassurance. Therefore, radiographic confirmation is the gold standard for ensuring the safe and accurate placement of an NG tube.