Types of tubes

• NG (nasogastric) tube
• OG (orogastric) tube
• Dobhoff/Keofeed - feeding tube with weighted tip to help peristalsis/transit into duodenum; more flexible/comfortable to patient?
• Weighted metal end seen on plain film

Positioning

• NG tube (suction and decompression)
• Terminates 10 cm past GE junction
• GE junction typically located at junction of hemidiaphragms
• Side port should be past the GE to feed
• Tip should be past the GE to suction
• Check positioning with a CXR (not AXR) - can see if too high (e.g. bronchus), and less radiation
• Feeding tube/Dobhoff
• Should be at Ligament of Treitz - in duodenum/past pylorus to reduce reflux (will be to right of spine)

Complications

• Get CXR after placement to rule out pneumothorax
• Beware of NG tube in the bronchus; get another CXR after removal to check for PNX
• Example:
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