If the tube does not pass below the
diaphragm feeding should not occur
It may be possible to advance the tube
if it is felt to be in the oesophagus, if the
NGT still has the guidewire in situ
In this situation aspirate may then be
obtained meaning a further X-ray would
be unnecessary
Obviously sometimes tubes do not
pass below the diaphragm due to being
coiled higher up as in this example
In this situation the tube should be
removed and resited
If there is a suspicion of any abnormal
anatomy causing this (e.g. pharyngeal
pouch) then fluoroscopic intubation
should be considered