Why are Chest X-Rays Used to Confirm OG Tube Placement?

When it comes to confirming the placement of an OG tube, why are chest X-rays such a common method? Is there a specific reason why other methods aren’t as reliable or accurate?

Medical professionals often use OG (orogastric) tubes to administer medication, fluids, or nutrients directly into the stomach. However, it is crucial to ensure that the tube is placed correctly to avoid potential complications. Chest X-rays have long been a standard method for confirming OG tube placement due to their ability to provide clear and definitive results.

Confirming OG tube placement is essential to prevent potential harm and ensure effective treatment. While there are alternative methods available, chest X-rays have proven to be reliable and accurate in determining correct tube positioning. Understanding the reasons behind this choice can help shed light on the importance of using chest X-rays in this context.

The Need for Confirmation of OG Tube Placement

Confirmation is important due to the possibility of incorrect placement. If positioned incorrectly, OG tubes can cause damage or irritation to the lungs, esophagus, or other surrounding organs and tissues. Chest X-rays are capable of providing a highly detailed image of the tube in relation to these other structures. This allows medical professionals to quickly and accurately identify any potential problems with placement before further treatment is administered.

How Chest X-rays Provide Visual Confirmation of OG Tube Placement

Chest X-rays create a two-dimensional image of the chest. This image highlights any foreign objects, such as an OG tube, and their exact location in relation to other organs and tissues. The X-ray also allows medical professionals to determine if the tube is positioned correctly by observing its angle of entry and exit from the stomach. Since the image can clearly show the location of an OG tube, this makes it a popular method of confirming correct tube placement. However, there are also certain disadvantages that we’ll detail below.

Downsides of Using Chest X-rays for OG Tube Confirmation

Radiation Exposure

One of the main downsides of using chest X-rays for OG tube confirmation is radiation exposure. X-rays use ionizing radiation to produce images, which can be harmful to the body if exposed to high doses over time. While the amount of radiation from a single chest X-ray is generally considered safe, repeated exposure comes with increased risk.


Chest X-rays can be expensive, especially if they are not covered by insurance. The cost of the X-ray itself, as well as any additional fees for interpretation by a radiologist, can quickly add up. This can be a significant financial burden for patients, particularly those without insurance or with high deductibles.


Getting a chest X-ray to confirm the placement of an OG tube can be time-consuming. Medical staff may have a busy schedule, wait for the X-ray to be taken, and then wait for the results to be interpreted by a radiologist. This can lead to delays in starting or adjusting tube feedings, which may impact the patient’s nutritional status and overall health.


For patients who are already hospitalized or have limited mobility, going to the radiology department for a chest X-ray can be inconvenient. It may require transportation, navigating through different areas of a hospital or facility, and potentially waiting in a crowded waiting room. This can be physically and emotionally taxing for patients, especially those who are already ill or in pain.

False-Positive or False-Negative Results

Chest X-rays are not always accurate in confirming the placement of an OG tube. There is a risk of false-positive results, where the X-ray may suggest that the tube is in the correct position when it is not. Conversely, false-negative results can occur, where the X-ray may not show any issues with the tube placement when there actually is a problem. These inaccuracies can lead to improper tube feedings, potential complications, and the need for further interventions.

Limited Visualization

Chest X-rays provide a two-dimensional image of the chest area, which may not provide a comprehensive view of the OG tube placement. It can be challenging to accurately assess the position of the tube in relation to other anatomical structures, such as the trachea, esophagus, or lungs. This limited visualization can increase the risk of misinterpretation and potential complications.

Alternatives to X-rays in Confirming OG Tube Placement

Gastric acidity verification is a procedure medical professionals can use to confirm the positioning of nasogastric (NG) or orogastric (OG) tubes in the stomach. It entails analyzing the pH level of the fluid extracted from the tube to ascertain if it is consistent with the pH for stomach acid, which verifies correct placement.

There are advantages to using gastric acidity verification over X-rays for tube placement confirmation.

  • More accurate: Gastric acidity verification is a more accurate and reliable method of confirming tube placement in the stomach. X-rays can be inconclusive or misleading, especially if there is overlap or displacement of the tube within the gastrointestinal tract.
  • Time-efficient: Gastric acidity verification is completed at the patient’s bedside and provides immediate confirmation of tube placement. Conversely, you need to wait for a time slot in radiology,  transport the patient to get the scan, and wait for the results, which delays caring for the patient.
  • Cost-effective: Gastric acidity verification has a significantly lower cost than X-rays. X-rays need additional equipment and radiology hours, which is expensive and time-consuming.
  • Ease of use: Gastric acidity verification is a straightforward and non-invasive procedure that can be conducted by a healthcare provider at the patient’s bedside. You don’t need specialized training or equipment, making it easily accessible and convenient.
  • Reduced radiation exposure:  X-rays use ionizing radiation, which can be potentially harmful with repeated exposure. Gastric acidity verification eliminates the necessity for X-rays, thus minimizing the patient’s radiation exposure.

Gastric acidity verification is a reliable and efficient method for confirming the placement of NG or OG tubes in the stomach, making it a preferred option over X-rays due to its cost-effectiveness and time efficiency.

Ready to Use Gastric Acidity Verification for NG/OG tube Placement?

Try RightSpotpH® Indicators for accurate placement of NG and OG tubes without X-ray, and improve patient safety and accuracy with reliable gastric acidity verification. Learn more by clicking here.

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