RightBio Metrics RightSpotpH Indicators
$81.00
The RightSpot pH Indicator from RightBio Metrics is a single-use, closed-system device that confirms nasogastric (NG) or orogastric (OG) feeding tube placement at the bedside by reading the pH of gastric aspirate. A small amount of stomach fluid is drawn into the sealed device, an internal strip changes color in seconds, and you read the result against the key on the unit, with no auscultation and often without an x-ray. It is a CLIA-waived, FDA-listed Class I in vitro diagnostic, billable under CPT 83986QW, and is supplied in the USA by Pacific Biomedical.
Why Bedside pH Confirmation Matters:
- Tube misplacement is a real risk. In a review of 9,931 blindly placed nasoenteric tubes, about 1.9% entered the airway, and nearly one in five of those caused a pneumothorax (Sparks et al., 2011).
- The auscultation or "whoosh" test is unreliable, correctly identifying tube location only about 34% of the time, and every major guideline now advises against it (Metheny et al., 1990; AACN; NPSA).
- pH testing is the guideline-recommended first-line bedside check (UK NPSA and ASPEN), and a clear gastric pH can avoid the delay and radiation of a confirmatory x-ray.
- Feeding through a misplaced tube is classed by the NHS as a Never Event, so placement must be confirmed before any feed, flush, or medication.
- The closed device keeps the aspirate sealed inside, so the clinician is not exposed to body fluids the way loose pH paper requires.
How The RightSpot pH Indicator Works:
- Confirm the tube is inserted to the intended depth.
- Attach the RightSpot indicator to an air-filled syringe and to the end of the NG/OG tube or its ENFit connector.
- Expel the air to move the tube tip off the stomach wall, then slowly draw a small amount (under 1 mL) of gastric fluid into the sealed device. Stop as soon as the color changes.
- Read the color against the reference key on the device within about 2 minutes. A reading of 5.5 or below indicates gastric placement.
- Dispose of the single-use device. The aspirate stays sealed inside.
Watch It In Action:
RightBio Metrics instructional video:
Choose The Right Version:
| Version | For tubes | Connector | Part number | Pack |
|---|---|---|---|---|
| Small Bore | NG/OG, 10 Fr or smaller (neonatal and pediatric) | Small bore | CDC-RSSB001-BX | 10/box |
| Large Bore | NG/OG, larger than 10 Fr | Large bore | CDC-RS001-BX | 10/box |
| ENFit | Any tube or syringe with an ENFit connector | ENFit (ISO 80369-3) | CDC-RSEN001-BX | 10/box |
Reading the pH:
A gastric aspirate pH of 5.5 or below is the guideline-recognized confirmation that the tube tip is in the stomach (the UK NPSA and ASPEN range is 1 to 5.5). Read the actual value against the device key rather than treating it as a single pass or fail line, and always follow the device instructions for use and your facility's policy. A pH of 6.0 or higher warrants further investigation, so do not feed: clear the tube with a little air, wait, and re-check, and escalate to x-ray for a high-risk patient, a high reading, or an unobtainable sample.
RightSpot compared with other confirmation methods
| Method | What it tells you | Key limitation |
|---|---|---|
| RightSpot pH indicator | Confirms gastric placement by pH at the bedside in a sealed, single-use device | A raised pH from acid-reducing medicines or continuous feeds can give a high reading; does not confirm post-pyloric placement |
| Loose pH paper or strips | Same gastric-pH principle at very low cost | Open system, so the aspirate must be handled; not a CLIA-waived device; coarse reading |
| Colorimetric CO2 detector | Flags a tube that has entered the airway | Cannot confirm the tube is in the stomach, and cannot tell stomach from esophagus |
| Auscultation (whoosh test) | Historically used, now discredited | Unreliable, correct only about 34% of the time; advised against by every guideline |
| X-ray | Definitive tip location, the gold standard | Radiation, cost, and delay; cannot be repeated before every feed |
| Electromagnetic or camera placement systems | Real-time guidance during insertion | High capital cost plus per-use disposables and training; guidelines still require a pH or x-ray confirmation |
Guidelines and Safety:
Major safety bodies align on pH-first confirmation. The UK NPSA names pH testing the first-line check with a safe range of 1 to 5.5 and x-ray as second-line. The NHS lists feeding through a misplaced naso or orogastric tube as a Never Event. The American Association of Critical-Care Nurses advises against the auscultation method, and ASPEN recommends gastric pH as the first-line verification method. RightSpot is a closed, CLIA-waived way to run that first-line pH check.
Specifications:
| Specification | Detail |
|---|---|
| Manufacturer | RightBio Metrics |
| Use | Confirm NG/OG/enteral tube placement by gastric pH |
| Method | Single-use colorimetric pH indicator, closed system |
| Versions | Small Bore (10 Fr or less), Large Bore (over 10 Fr), ENFit (ISO 80369-3) |
| Sample needed | Under 1 mL of gastric aspirate |
| Result time | Color develops in seconds, read within about 2 minutes |
| Pack size | 10 indicators per box |
| Single-use | Yes |
| Latex | Latex-free |
| Dating | Use before the printed expiration date |
| Storage | Sealed pouch at room temperature (rated minus 40 to 52 degrees C) |
| Regulatory | FDA-listed Class I IVD, CLIA waived, billable under CPT 83986QW |
Ordering and part numbers:
| Version | Part number | Pack |
|---|---|---|
| Small Bore (10 Fr or less) | CDC-RSSB001-BX (RSSB001) | 10/box |
| Large Bore (over 10 Fr) | CDC-RS001-BX (RS001) | 10/box |
| ENFit (ISO 80369-3) | CDC-RSEN001-BX (RSEN001) | 10/box |
Frequently Asked Questions:
What pH confirms an NG or feeding tube is in the stomach?
A gastric aspirate pH of 5.5 or below is the standard bedside confirmation that the tube tip is in the stomach (the UK NPSA and ASPEN range is 1 to 5.5). Read the actual value on the device key and follow the device IFU and your facility's policy. A pH of 6.0 or higher warrants further investigation, so do not feed and re-check placement.
How does the RightSpot pH Indicator work?
It attaches between the NG/OG tube (or its ENFit connector) and a syringe. You draw a small amount of gastric fluid into the closed device, and an internal pH strip changes color in seconds. You read the color against the reference key on the device. The fluid stays sealed inside, so you are not exposed to it.
What is the difference between the Small Bore, Large Bore, and ENFit versions?
Small Bore is for NG/OG tubes 10 Fr or smaller, Large Bore is for tubes larger than 10 Fr, and ENFit connects to any tube or syringe with an ISO 80369-3 ENFit connector. All three use the same pH technology and come 10 per box.
Which version do I need for a neonatal or pediatric tube?
Use the Small Bore version. It fits the fine-bore tubes (10 Fr or less) common in neonatal and pediatric care.
How much gastric fluid do you need?
Very little, under 1 mL and often just a few drops. Stop drawing as soon as the color changes.
What if you cannot get any aspirate?
Instill a small air bolus to clear the tube (the device procedure uses about 1 to 3 mL, or a little more than the tube's prime volume for an in-dwelling tube), reposition the patient onto their left side, wait about 10 minutes, and try again. Follow the device IFU and your facility policy.
What does a pH of 6.0 or higher mean?
A reading of 6.0 or higher warrants further investigation. It may mean the tube is not in the stomach, or that acid-reducing medicines or a continuous feed have raised the pH. Do not feed: clear the tube with a little air, wait, and re-check, and use an x-ray or another method if it stays high or you cannot get a sample.
Can it be used on patients taking acid reducers like PPIs or H2 blockers?
It can, but acid-reducing medicines can raise gastric pH and give a higher reading. Where possible, test before a dose or wait about two hours for the stomach to re-acidify. If the pH still reads high, confirm placement another way per your facility's policy.
How do you check NG tube placement?
Confirm the insertion depth, aspirate a small amount of gastric fluid, and test its pH. A pH of 5.5 or below confirms gastric placement, and many protocols also require an x-ray before the very first use. Re-check before every feed, flush, or medication, after any tube movement, and whenever displacement is suspected.
What are the signs an NG tube is in the lungs?
Coughing, choking, gasping, breathlessness, an inability to speak, no aspirate, or a pH of 6 or higher can indicate the tube has entered the airway. These signs can be subtle or absent, so always confirm with pH or x-ray rather than relying on symptoms. Stop and do not feed until placement is confirmed.
Can you feed or give medication before confirming placement?
No. Never give a feed, flush, or medication until placement is confirmed by pH or x-ray. The NHS classes feeding through a misplaced tube as a Never Event.
Why is the auscultation (whoosh) test no longer recommended?
It is unreliable. In published testing it identified tube location correctly only about 34% of the time and cannot tell the stomach from the lung, so NPSA, AACN, and ASPEN advise against using it.
Is x-ray still the gold standard, and when is it needed?
An x-ray that shows the whole tube is the definitive check, and many protocols require it before first use. Bedside pH is the recommended first-line test and reduces how often an x-ray is needed. Escalate to x-ray when the pH is 6 or higher, you cannot get a sample, or the result is unclear.
How does RightSpot compare to loose pH paper strips?
Both use gastric pH. RightSpot is a closed, single-use device, so the aspirate stays sealed inside and is read through the device, while loose pH paper requires handling the aspirate. RightSpot is also a CLIA-waived in vitro diagnostic and is designed to read cleanly even when the aspirate is cloudy or discolored.
Is it FDA registered and CLIA waived, and what is CPT 83986QW?
It is an FDA-listed Class I in vitro diagnostic and is CLIA waived, so it can be run as a point-of-care test under a CLIA Certificate of Waiver. Gastric pH testing is billable under CPT code 83986QW.
Is the indicator single-use and latex-free, and how is it stored?
Yes, each indicator is single-use and latex-free. Store the sealed pouches at room temperature and use before the printed expiration date.
Can it read cloudy or discolored aspirate?
The sample fills the chamber from behind the indicator paper, which is designed to give a readable color even when the aspirate is cloudy or discolored.
How fast does it give a result?
The color develops within seconds. Read it against the device key within about two minutes for a valid result.
Can the indicator be reused?
No. Each indicator is single-use. Use a new one for every check and dispose of it per your facility's policy.
Can it be used at home by caregivers?
Yes. It is used in hospitals, EMS, and home care, so a trained caregiver can confirm placement before a home tube feed by following the device instructions for use.
How is NG tube insertion depth measured?
Insertion depth is estimated against the body, traditionally nose to earlobe to xiphisternum (NEX), with nose to earlobe to mid-umbilicus (NEMU) often preferred as more accurate. A pH check is still required after placement.
Always follow the device instructions for use and your institution's policy for confirming feeding tube placement. Supplied by Pacific Biomedical.
| Item # | Image | In Stock | Quantity |
|---|---|---|---|
|
RightBio Metrics RightSpotpH ENFit Indicator, 10/Box CDC-RSEN001-BX |
|
$85.00 10-bx |
|
|
RightBio Metrics RightSpotpH Large Bore Indicator, 10/Box CDC-RS001-BX |
|
$115.00 10-bx |
|
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RightBio Metrics RightSpotpH Small Bore Indicator, 10/Box CDC-RSSB001-BX |
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$81.00 10-bx |