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Updated: Jun 26, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Development of a clinical practice guideline for testing nasogastric tube placement
1Ambulatory Care, Princess Margaret Hospital for Children, Child & Adolescent Health Service, Subiaco, Perth, WA, Australia. sue.peter@health.wa.gov.au
Purpose:
A Perth metropolitan hospital group standardized changes to nasogastric tube placement, including removal of the "whoosh test" and litmus paper, and introduction of pH testing.
Design And Methods:
Two audits were conducted: bedside data collection at a pediatric hospital and a point-prevalence audit across seven hospitals.
Results:
Aspirate was obtained for 97% of all tests and pH was < or = 5.5 for 84%, validating the practice changes. However, patients on continuous feeds and/or receiving acid-inhibiting medications had multiple pH testing fails.
Practice Implications:
Nasogastric tube placement continues to present a challenge for those high-risk patients on continuous feeds and/or receiving acid-inhibiting medications.
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