Abstract
Nasogastric tubes (NGTs) are routinely used in clinical settings for feeding, medication administration, and gastric decompression, particularly in critically ill or intubated patients. Confirming the accurate placement of an NGT is essential to avoid serious complications such as aspiration or the formation of a pneumothorax. While medical imaging, especially chest and abdominal X-rays, is considered the gold standard for confirming placement, repeated use contributes to increased patient exposure to ionising radiation. This has raised concerns regarding long-term health risks, particularly in vulnerable or frequently imaged populations. Despite these risks, imaging continues to be heavily relied upon, and the perceptions of physicians on this practice remain underexplored, especially in the South African context.
This qualitative, exploratory, and descriptive study investigated the perceptions of physicians regarding the use of medical imaging for NGT placement. The research was conducted in both public and private hospitals in Johannesburg, South Africa. Data was collected through semi-structured interviews with ten physicians from various specialities, including anaesthesiology and internal medicine. An interpretivist paradigm was used for the research, and data was analysed using thematic analysis with an inductive approach.
Participants recognised the accuracy of medical imaging for confirming NGT placement but often preferred clinical methods like auscultation and aspiration in urgent or resource-limited settings. Their choices were influenced by clinical experience, workflow constraints, and anticipated imaging delays. While there was general awareness of radiation risks, these were seen as minimal compared to the benefits of imaging. Some showed interest in alternatives like ultrasound, though barriers such as equipment and training were noted. Overall, the study highlights a need for greater awareness of safer alternatives, improved access to resources, and clearer clinical protocols.