Quality of Communication: Different Patterns of Reporting the Location of the Tip of a Nasogastric Tube

Purpose: This investigation is part of a prospective National Institutes of Health-funded study evaluating three different methods for estimating the optimal length for placement of a new nasogastric (NG) tube. Abdomen radiographs were required to determine the location of the tube tip. Our objective was to analyze different methods by which the tube location was described in the radiology report of the abdominal radiographs, and the influence of the presence or absence of a relevant clinical history. Methods: We reviewed the imaging reports obtained following placement of a new nasogastric tube in patients enrolled in the study. Results: There were 188 studies. The x-ray report contained separate description and impression sections in 154. In 24 they were combined. When the history on the requisition indicated "tube placement" as the reason for the study, the location of the tube tip was given in the impression on 134/141 (95%). When the requisition failed to mention "tube placement" as the study indication, the impression only mentioned the tube tip location 4/13 (31%). The report provided a specific location for the tube tip in 115 of the 188 cases; in 73 of the 188 cases, the report stated that the tube tip "overlies/is in the region of" the stomach. On 29 occasions the report stated that the tube, not the tube tip, was in the stomach. Conclusions: There is variation in the manner of reporting the location of NG tube tips. When the requisition fails to indicate "tube placement" as the study indication, the report impression often fails to mention the tube location.