Lines and tubes (radiograph)

Last revised by Craig Hacking on 18 Feb 2024

Lines and tubes are important components in chest radiographic evaluation.

Nasogastric tube (NGT)

See: nasogastric tube positioning

Correct position
Nasopharyngeal airway tube (NPAT)

See: nasopharyngeal airway tube

Correct position
  • Tip immediately above the epiglottis

  • risk of intracranial positioning in patients with basal skull fracture

Endotracheal tube (ETT)

See: evaluation of endotracheal tube position.

Correct position
  • ETT tip 5 cm +/- 2 cm above carina

  • selective intubation (contralateral lung collapse/hyperinflation of ipsilateral lung/pneumothorax)

  • tooth aspiration

Central venous line/catheter (CVL/CVC)
Correct position
Intercostal tube/catheter (ICC)

See: intercostal catheter

Correct position
  • intercostal tube tip lies between visceral and parietal pleura

  • placement into lung parenchyma, interlobar fissure or subcutaneous tissue

  • mediastinal or abdominal visceral trauma

  • re-expansion pulmonary edema

Permanent pacemaker (PPM)
Correct position
  • single chamber: electrode tip in right atrial appendage (atrial pacing) or right ventricular apex (ventricular pacing)

  • dual chamber: electrode tips in right atrium and right ventricular apex

  • biventricular: electrode tips in right atrium, right ventricle and coronary sinus

  • implantable converter defibrillator: electrode tip in apex of right ventricle

Temperature probe

See: temperature probe

Correct position
  • in the upper to mid thoracic esophagus

  • placement into trachea or bronchus

  • pneumomediastinum

  • pneumothorax

Pericardial drain
Correct position
  • usually inserted on the left of midline into the pericardial space

Intra-aortic balloon pump (IABP)

See: intra-aortic balloon pump

Correct position
  • tip at the level of the AP window

  • aortic dissection

  • obstruction of the left subclavian artery (too high)

  • obstruction of the splanchnic arteries (too low)

See also

Systematic chest radiograph assessment:

  1. projection

  2. assessment of the technical adequacy

  3. tubes and lines

  4. cardiomediastinal contours

  5. hila

  6. airways, lungs and pleura

  7. bones and soft tissue

  8. review areas

ADVERTISEMENT: Supporters see fewer/no ads

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.