Although often considered an innocuous procedure, bedside placement of a feeding tube can cause serious and even fatal complications.1–3  Although styleted small-bore tubes are most often associated with complications, large-bore tubes without stylets are not without risk.1,4–6  In a study of 9931 blindly inserted narrow-bore nasoenteric tubes, 1.9% were placed in the tracheobronchial tree; of the 187 tube misplacements, 35 cases of pneumothoraces (at least 5 of which resulted in a patient’s death) occurred. In rare situations, feeding tubes may also be inadvertently positioned in the brain, especially in patients with a traumatic defect.4,8–10  Risk for aspiration is greatly increased when a feeding tube’s ports end in the esophagus.1,11 

Noting signs of respiratory distress:

Capnography:

Measuring pH and assessing appearance of the aspirate:

Listening over the...

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