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A height based graphic method was more accurate than estimation based on external landmarks for determining depth of paediatric gastric tube insertion

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QUESTION: Is a graphic method for determining depth of gastric tube insertion based on paediatric patient height more accurate than the traditional method based on measurements from the external landmarks of the nose or mouth, to the earlobe, to the xiphoid process (NEX method)?


Randomised {allocation concealed}*, blinded (outcome assessors), controlled trial with immediate follow up.


The emergency department of a university affiliated children’s hospital in {St Louis, Missouri, USA}*.


89 children who were 6 months to 18 years of age and needed gastric intubation in the emergency department. Exclusion criteria were previous oesophageal surgery, known congenital abnormalities of the oesophagus, or need for emergency placement of the gastric tube (eg, critically ill trauma and ingestion patients in which obtaining study consent might have delayed treatment). Data from 88 children (99%) were included in the analysis (mean age 54 mo, …

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  • Source of funding: no external funding.

  • For correspondence: Dr AE Klasner, University of Alabama, Birmingham, AL, USA. aklasner{at}

  • * Information provided by author.