A Low-Cost, Point-of-Care Test for Confirmation of Nasogastric Tube Placement via Magnetic Field Tracking

Muneaki Miyasaka, Hao Li, Kon Voi Tay, Soo Jay Phee, Muneaki Miyasaka, Hao Li, Kon Voi Tay, Soo Jay Phee

Abstract

In this work, we aim to achieve low-cost real-time tracking for nasogastric tube (NGT) insertion by using a tracking method based on two magnetic sensors. Currently, some electromagnetic (EM) tracking systems used to detect the misinsertion of the NGT are commercially available. While the EM tracking systems can be advantageous over the other conventional methods to confirm the NGT position, their high costs are a factor hindering such systems from wider acceptance in the clinical community. In our approach, a pair of magnetic sensors are used to estimate the location of a permanent magnet embedded at the tip of the NGT. As the cost of the magnet and magnetic sensors is low, the total cost of the system can be less than one-tenth of that of the EM tracking systems. The experimental results exhibited that tracking can be achieved with a root mean square error (RMSE) of 2-5 mm and indicated a great potential for use as a point-of-care test for NGT insertion, to avoid misplacement into the lung and ensure correct placement in the stomach.

Keywords: magnetic sensors; real-time systems; wearable sensors.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Overview of the two-sensor-based magnetic NGT tracking system.
Figure 2
Figure 2
Dimensions of the esophagus and airway where the NGT can enter.
Figure 3
Figure 3
Top: Illustration of the search regions, global search range, and instantaneous search range. Bottom: Definition of pitch and roll rotations and the origin of the magnet (Om).
Figure 4
Figure 4
(a) The first experimental setup to test the position tracking accuracy. (b) The tracking accuracy was evaluated at the 15 locations indicated in blue dots.
Figure 5
Figure 5
Mock-up esophagus and airway for the second experiment. The 14 FG NGT with a magnet is manually inserted into each path (esophagus, right airway, and left airway).
Figure 6
Figure 6
The average y and z position error and SD for L = (a) 80 mm and (b) 100 mm.
Figure 7
Figure 7
The average position error and SD along z-axis for (a) y position and (b) z-position. The results for both L = 80 and 100 mm are shown.
Figure 8
Figure 8
Tracking experiment with the dimensionally accurate mock-up esophagus and airway when L = 80 mm. Three trials of inserting the NGT into each path (the esophagus (black), right airway (blue), and left airway (red)) are shown in (a–c). The inner diameter of the esophagus and trachea is represented by the yellow vertical dashed lines. The horizontal dashed line indicates the vertical location of the sensors.
Figure 9
Figure 9
Tracking experiment with the dimensionally accurate mock-up esophagus and airway when L = 100 mm. Three trials of inserting the NGT into each path (the esophagus (black), right airway (blue), and left airway (red)) are shown in (a–c). The inner diameter of the esophagus and trachea is represented by the yellow vertical dashed lines. The horizontal dashed line indicates the vertical location of the sensors.

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