NG tube: ultrasound is a scout, not clearance

Question 1Where does the cervical oesophagus usually lie on a transverse neck scan?

1. aIn front of the thyroid
2. bTo the right of the right carotid
3. cBehind and to the left of the trachea
4. dInside the carotid sheath

Question 2How does the trachea look on ultrasound?

1. aA bright curved line with reverberation artefact below it
2. bA round target with a bright centre
3. cA pulsatile anechoic circle
4. dA black fluid-filled circle

Question 3How does a nasogastric tube look in the oesophagus in transverse?

1. aA dark ring around the carotid
2. bA comet tail on the pleura
3. cA bright echo with a shadow inside the oesophagus
4. dFluid in the thyroid

Question 4In UK practice, what confirms nasogastric tube position before first use?

1. aSeeing the tube in the neck on ultrasound
2. bThe whoosh test
3. cAspirate pH 1 to 5.5, or a correctly interpreted chest X-ray
4. dThe patient not coughing

Question 5The tube cannot be seen on the neck scan. What does that mean?

1. aIt is in the trachea
2. bNothing on its own: follow the pH or X-ray pathway
3. cIt has fallen out
4. dIt is in the stomach