Introduction: Nasogastric tubes (NGTs) are enteral access devices used to provide nutrition to critically ill patients requiring intensive care, or to improve surgical conditions in patients undergoing certain surgeries. The insertion of NGTs is particularly challenging in patients who are anaesthetised and intubated; complication rates are higher and initial success rates are often lower in this population. Misplacement of NGTs is often associated with potentially serious complications. This dissertation assessed the common practice of NGT insertion and investigated how improving the process through the use of a dedicated introducer device may reduce patient complications. Methods: Three research projects were performed. The first was a prospective multicentre service evaluation which assessed a sample of NGT insertion in clinical practice across three Irish hospitals for methods used, success rates, and other variables. The second was a survey of practicing anaesthesiologists which assessed their opinions on and attitudes towards NGT insertion in general. Thirdly, a mannequin-based study was performed in which a prototype nasogastric tube introducer device was compared to standard insertion methods. A literature review was performed which examined much of the available evidence on NGT insertion in anaesthetised patients, including insertion methods and complication rates. Results: The “blind” method of inserting NGTs was the most common initial technique used, and it is a prevalent method across the world for intubated patients. Several other techniques are described in the literature, all of which have both advantages and disadvantages, but may be superior to the “blind” method which has the lowest success rate. Pulmonary NGT misplacements identified in the study had used the blind method for insertion in 83% of cases. Many anaesthesiologists agree that NGT insertion in intubated patients can be challenging, and there is a willingness to try new techniques which may be more reliable. A prototype introducer device was found to reduce insertion times in a mannequin study when compared to other methods. Conclusions: NGT insertion in intubated patients is technically challenging and potentially dangerous. A more reliable method is needed, but it must be safe and effective and should be easy to use. A dedicated device may be useful.