The Background

Usability study of pH strips for nasogastric tube placement
Simone Borsci, Peter Buckle, Jeremy Huddy, Zenia Alaestante, Zhifang Ni, George B. Hanna

Results from an audit examining the viability of pH indicator strips for nasogastric tube placement found participants made up to 11.15% errors reading the strips and reported anxiety in their use.1

Study results supported the development of new pH indicator strips that are more usable and less likely to be misread.1


CE (IVD) marked for testing human gastric aspirate for the assessment of correct nasogastric tube placement

Test data demonstrated 100% accuracy at clinical decision values

Test data on file demonstrated accuracy / results at clinical decision values 4.0, 4.5, 5.0 & 5.5.


Before any liquid or feed is introduced into a nasogastric tube, confirmation that the tube tip is in the stomach, by pH testing or x-ray, must be completed.2,3

Testing the pH of gastric aspirate to show pH ≤5.5 is the recommended first-line test to confirm correct placement of nasogastric tubes and reduce the risk of potentially fatal aspiration.2–5

Since the completion date for that Alert’s actions (1 September 2005), the NRLS has received reports of a further 21 deaths and 79 cases of harm due to feeding into the lungs through misplaced nasogastric tubes.2

Confidence and reassurance

The accuracy of the aspHirate pH Indicator strips is supported with independent test data.

Key Features

Increased confidence for consistent results

How do we know that aspHirate strips are accurate?

aspHirate pH Indicator strips are tested and calibrated using pH buffers that are traceable to NIST (National Institute of Standards and Technology). The pH buffers have also been checked using a NIST-calibrated pH meter.

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  1. Borsci S, et al. PLoS ONE 2017;12(11):e0189013.
  2. NPSA. Reducing the harm caused by misplaced nasogastric feeding tubes in adults, children and infants. NPSA/2011/PSA002. 2011.
  3. NNNG. Good Practice Guideline – Safe insertion of nasogastric (NG) feeding tubes in adults and ongoing care. 2016.
  4. NHS PSA. Nasogastric tube misplacement: continuing risk of death and severe harm. NHS/PSA/RE/2016/006. 2016.
  5. Rowat AM, et al. BMJ Open Gastroenterol 2018;5:e000211.

NIST, National Institute of Standards and Technology; NNNG, National Nurses Nutrition Group; NSPA, National Patient Safety Agency; NWSPP, NHS Wales Shared Services Partnership; SMTL, NHS Surgical Materials Test Laboratory.

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