Nasogastric tube Placement under Sonographic Observation: a comparison study of ultrasound and chest radiograph in mechanically ventilated patients

Ultrasound of the neck and stomach in transverse and longitudinal planes of a patient who has an existing Nasogastric tube. This will be done in order to compare against a chest x-ray to assess accuracy of ultrasound nasogastric tube position verification. This will be done by Medical Officers (Registrar) with 6 months intensive care experience. Medical officers will have a powerpoint presentation outlining protocol and the procedure. The medical officers will also be supervised for their technique and adherence to protocol and deemed competent to commence enrollment by a senior consultant or primary investigator. This intervention will be performed face to face with the patient with the registered nurse present. The intervention will be performed a maximum on two times for a duration of under 10 minutes unless patient deterioration takes priority. The intervention will take place in the Intensive Care Unit bedspace that the patient is allocated to. The intervention will not be personalised, adapted or titrated to any groups of individuals. The intervention adherence will be recorded on a data collection form which will highlight nasogastric tube type, size, insertion depth, consent gained, inclusion criteria met, exclusion criteria assessed, and study findings. Images taken with the ultrasound machine are re-identifiable. Consultants will be available to assist at all times with any concerns or quarries. Registrars will have access to resources and materials required such as protocols and fact sheets. All nasogastric tubes will be radiologically verified before use as per hospital policy.