Nasogastric/Orogastric Tube Placement Verification Study Using RightSpot pH Indicator to Verify Gastric Acidity

Primary objective:

To assess the level of accuracy of the RightSpot pH Indicator in determining correct
placement of NG/OG tubes as compared to the gold standard of CXR in Emergency Department &
ICU patients.

Hypothesis 1: In greater than 90% of the cases, RightSpot pH Indicator will be successful in
confirming the placement of NG/OG tubes by demonstrating a pH of 4.5 or less in patients
with CXR proven tube placement.

Hypothesis 2: The time to confirmation of NG/OG tube placement will be significantly less
using the RightSpot pH Indicator than using CXR. The time will be calculated by the start
time consisting of the time that the NG/OG tube was placed until the end time, which will be
when the device pH Indicator testing is performed. The time to confirmation using the gold
standard of a CXR will begin when the NG/OG tube is placed and end when the CXR is available
on PACS (picture archiving and communication system).

Secondary objective:

To determine via subgroup analysis whether gross blood in the stomach, presence of
acid-reducing medications, or trauma affects the accuracy of NG/OG placement determination
by the RightSpot pH Indicator.

Inclusion Criteria:

- Patients 18 years and older

- Patient or proxy willing to provide informed consent

- Patients who require placement of a nasogastric/orogastric tube, in the ED or ICU, as
standard of care, AND a member of the study staff is available and present for NG/OG
tube placement.

- It is anticipated that the patient will remain in the ED/ICU in order to obtain
RightSpot pH Indicator reading and verifying CXR

Exclusion Criteria:

- Patients less than 18 years of age

- Patient or proxy unwilling or unable to provide informed consent

- Patient with known or suspected pregnancy