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Probably the most accurate way is by an x-ray, but that is just not practical, so lets mention 3 more ways.

. You need a stethoscope, a syringe, a kidney dish and litmus paper.

1. use a syringe to inject air down the top of the tube while you are using a stethoscope placed over the patient's stomach. If you hear bubbles, it is the air bubbling in the gastrc juices and it confirms that the tube is in the stomach and not the lungs.

2. use the same syringe to withdraw some of the fluid you just heard bubbling. It should be green or yellow and should test acid on Litmus paper. By doing that, you have verified that the tube is in the stomach.

Explaining it, it sounds like it takes a long time, but in practice it takes less than a minute, and it should be done before each and every nasogastric feed, without fail.

There is a 3rd way which I definitely do not recommend. It involves using a syringe to inject 5 ml of sterile water or Normal Saline down the tube to see if the patient coughs, which would show that the tube was in the lungs.

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