Nasogastric tube incidents and the use of the 'whoosh test'

If an aspirate is not obtainable once the NGT is sited, performing the whoosh test is a valuable means to assess the likelihood of the NGT being in the stomach or not. If a positive whoosh test is heard, then a chest radiograph (CXR) can be requested. If the whoosh test is negative, then there is little point in requesting a CXR as the probability of the NGT being in the stomach is very low (in my experience). Performing an unnecessary CXR on an intensive therapy unit patient carries risks of radiation (to patient, adjacent patients and staff), of unnecessary rolling (in patients with potential spinal injuries), and of unnecessary use of intensive therapy unit and radiology staff time and resources.