Prior to performing this procedure, the patient's medical and nursing notes should be consulted to check for potential complications. For example, anatomical alterations due to surgery, such as a flap repair, or the presence of a cancerous tumour can prevent a clear passage for the nasogastric tube, resulting in pain and discomfort for the patient and further complications. Patients who have recurrent retching or vomiting, who have swallowing dysfunction or are comatose have a high risk of placement error or migration of the tube so care must be taken when placing a nasogastric tube under these circumstances (NPSA [181]). Any patient with coagulation derangements should have these corrected prior to insertion (Curtis [57]). The nurse should clearly document the assessment of the patient, the risks and the patient's consent.