NG Tube Positioning and Confirmation for Safe NG Feeding Tube Placement


March 21,2023


NG Feeding Tube Positioning Needs Confirmation to Avoid Complications 

Proper NG feeding tube positioning is extremely important to safe placement. When nutrition fails because of illness, pathology, or incapacitation, the solution is feeding via safe feeding tube placement without complications. 

One such complication is accidental lung collapse from misguiding an NG tube, damaging the lung. Another is aspiration pneumonia from aspirating stomach contents. 

stomach contents. 

ENvizion Medical’s ENvue system is designed to perfect the safety record of NG tube placement.


Safe NG Feeding Tube Positioning is Difficult Without Actually Observing Nasogastric Tube Placement

NG feeding tube is necessary for a patient unable to feed, swallow, and consume the appropriate diet. Safety should be part of the nasogastric feeding tube placement procedure and correct placement establishes that safety. 

The proximity of the entrances of both the gastrointestinal (esophagus) and breathing (trachea) tracts makes threading a feeding tube a hazardous journey. Normally, the epiglottis closes protectively over the entrance to the trachea during swallowing. Despite this, a passing feeding tube still can be inadvertently misdirected the wrong way, toward the lungs.

The right NG feeding tube positioning is thus crucial to prevent such serious, even life-threatening, complications. The only correct position for an NG feeding tube is in the gastrointestinal tract. 

ENvizion Medical invented a solution to prevent injury and death that occurs too often from complications of NG feeding tube positioning and placement. Their product, the ENvue System, has an external electromagnetic field generator that tracks feeding tube placement with integrated navigation sensors and body mapping. This provides safe and rapid feeding tube placement.

Safe NG Feeding Tube Positioning Means Immediate Confirmation of Safe Nasogastric Tube Placement 

Even when correct NG feeding tube positioning is confirmed by X-ray, it is usually several well after the procedure. Waits of an hour or longer can even occur. Should X-ray confirm improper NG tube positioning, waiting for such confirmation is the same as allowing a complication to continue all that time. 

The safest protocol is one that informs immediately, as the feeding tube is being inserted. The timeline of an uncorrected misplacement of a feeding tube adds danger to the patient exponentially. Timely identifying misplacement avoids the following complications:

  • Pneumothorax: Punching a hole through the covering over the lung will result in unrestricted air leakage into the chest cavity. That pressure presses on the injured lung, collapsing it down and making it non-functional. What follows is severe pain, hypoxia, and possible death. The ENvue system eliminates the risk of pneumothorax.

  • Occult pneumothorax: Worse, sometimes the presence of the misplaced tuber can block the air escape, like a plug. The lung, damaged but maintaining its volume, presents a falsely reassuring clinical picture. When the misplacement is discovered and the tube removed, however, the pneumothorax can then proceed as a completely unexpected complication. 

  • Delay in starting nutrition: Holistically, nutrition is the keystone to healing, and providing it should be considered an emergency. A feeding tube can fall short of reaching the small intestines when being placed for post pyloric feeding. Crossing through the pylorus is difficult and is the most common cause of post pyloric feeding tube placement failure. Nutrition delivered to the stomach is not complete when compared to what intestinal absorption offers. When preferred over an NG tube, the ENvue system facilitates passing through the pylorus to ensure proper nutrition. 

  • Aspiration Pneumonia: The upper and lower esophageal sphincters prevent reflux of stomach contents into the pharynx. When these remain partially open due to the manipulation of a feeding tube, such reflux can be inhaled, called aspiration. The gastric contents are not sterile and carry infectious organisms into the otherwise sterile inner lung. While aspiration can occur in even proper feeding tube placement, misplacement into the esophagus or stomach instead of post-pyloric insertion impairs gastric emptying and increases the risk of aspiration unacceptably. 

Any of these concerns makes immediate knowledge of trouble the safest case scenario for the patient. The ENvue System has been designed from the ground up to create instant recognition of misplacement, as well as facilitate post-pyloric placement should that be desired.

How to Safely Place an NG Feeding Tube

A review of the different methods for inserting an NG feeding tube compares and contrasts the benefits and risks: 

  • Blind placement. In this method, the tube is passed through the mouth or nostril to the pharynx and farther down after that. This has a high rate of complications, including tension pneumothorax and aspiration pneumonia. Additionally, it is only successful on the first try in 44% of patients. Additional tries increase the complication rate.

  • Blind NG tube positioning and placement with follow-up X-ray confirmation. This method is considered the gold standard for verification of proper placement. However, the risk of delayed diagnosis via X-ray is some time after a complication has already begun and proceeds. 

  • Placement via ultrasound. This is cumbersome to the point of clinical staff avoiding it altogether, making it uncommon. Also, the extra time in doing it this way increases the risk of complications. 

  • Fluoroscopic guidance, while allowing real-time observation of placement progress, is also cumbersome, squanders hospital resources, and exposes the patient to additional unnecessary radiation. It also suffers from its limited 2-dimensional imaging; compare this to the multi-planar display of the ENvue system.

  • Endoscopic guidance, likewise, also provides real-time tracking but, also likewise, squanders hospital resources. Additionally, the delay in scheduling a procedure in the GI department causes unnecessary delay in beginning nutrition for healing-the whole point of feeding tube placement.

  • Electromagnetic guidance. State-of-the-art technology reduces complications by following the feeding tube’s path in real time. A disastrous turn toward the lungs is immediately recognized and complications averted. Even an intended wrong turn can be predicted.

Thus, of all the ways to pass an NG feeding tube, today’s electromagnetic guidance eliminates all the failings of other methods. Aside from blind placement with the highest complication rate, ENvizion Medical’s ENvue System immediately alarms the clinical staff of incorrect aiming of the tube. 

This benefit far surpasses the delay in its recognition via X-ray. It also prevents repeated and unnecessary X-radiation exposure to the patient. 

ENvizion Medicals’ ENvue System Helps in NG Tube Positioning 

Nvizion Medical has invented an innovative advance in NG tube positioning and placement safety. Its ENvue system significantly reduces the risk of injury and death that occurs from complications placing NG feeding tubes. 

Their product, an electromagnetic feeding tube placement system, is a leap forward in technology. 

An electromagnetic field is generated external to the patient. The feeding tube incorporates navigation sensor whose position and orientation can be read and displayed in real time. Integral to this advance is the additional safeguard in which each patient’s unique contour is mapped and displayed in three simultaneous views (Frontal, Lateral and Axial). 

These are additional graphics depicted, using non-invasive methods, to further overlay these personalized landmarks on the screen. 

Thus, today, a patient requiring NG feeding can undergo insertion with integrated navigation sensors and body mapping to provide safe and rapid NG tube positioning and placement.


The ENvue system, invented by ENvizion Medical, creates a new standard of excellence for safety in NG feeding tube positioning and placement. 

Crucially informative in real time, even the direction of the tip can predict a wrong turn before it happens. No one needs to suffer life-threatening complications or death because of the insertion of a feeding tube ever again. 

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