Enteral nutrition is often considered to be simpler than parenteral nutrition. Although nasogastric feeding is relatively common in hospital and gastrostomy feeding is the most common form of tube feeding in the community, in the past few decades more complex enteral access routes have become available and these may require specialist intervention by healthcare professionals, both for tube insertion and maintenance.
Despite the frequent use of nasogastric tubes for nutrition, an excellent standard of care is needed to avoid the hazard of feeding down an inappropriately placed nasogastric tube – this is a “never event” in NHS England (http://www.nrls.npsa.nhs.uk/resources/collections/never-events/core-list/misplaced-naso-or-orogastric-tube-not-detected-prior-to-use/). pH testing of aspirate is the recommended first-line method of checking tip position for nasogastric tubes and Chest X-ray second-line. X-rays must be interpreted by appropriately trained staff as misinterpretation has been the cause of a number of complications and deaths.