Even though bedside placement of feeding tubes is common in intensive care units, and usually not harmful, feeding tube placement can cause serious and fatal complications. Feeding tubes have been misplaced in the tracheobronchial tree and, in rare situations, in the brain, especially in patients with traumatic defect. In addition, risk for aspiration is greatly increased when the ports of a feeding tube end in the esophagus.

Use a minimum of 2 bedside techniques to assess tube placement during the insertion procedure:

(1) observe for signs of respiratory distress; (2) use capnography if available; (3) measure pH or aspirate from tube; and (4) observe the characteristics of tube aspirate.

Do not use the auscultatory (air bolus) method to determine tube location.

Do not use the water bubbling method (holding tube under water) to determine tube location.

Recommend radiographic confirmation of correct placement of a blindly inserted small-bore or large-bore tube...

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