The Nasogastric Tube in the Thorax after Gastric Pull Up! (original) (raw)
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A malfunctioning nasogastric feeding tube
Nutrición hospitalaria
A critical point of nasogastric feeding tube placement, potentially resulting in an unsafe and/or non-effective operation of the device, is the monitoring of its proper placement into the stomach. A properly obtained and interpreted radiograph is currently recommended to confirm placement. We reported the case of a 68-year-old demented woman referred for complicated dysphagia. A nasogastric tube was blindly inserted and its placement was confirmed by the radiologist. Enteral nutrition was initiated but the patient began to vomit immediately. After reviewing the radiograph it was understood that a gastric loop in the tube and its tip pointing upwards did not allow a safe infusion of the feeding formula. It is not enough having the radiologist reporting that a nasogastric feeding tube is placed in the stomach; the inclusion in the report of specific warnings on any potential cause of malfunctioning of the device should be considered. The presence of a gastric loop should be taken into...
Down the Wrong Way: An Important Complication of Nasogastric Tube Placement
Journal of Medical Cases, 2014
Placement of a nasogastric tube is a very common procedure carried out by doctors and nurses on both medical and surgical wards. Indications include for feeding purpose to meet the patient's nutrition requirement and a therapeutic use to decompress a distended bowl in an acute small/large bowl obstruction. Insertion of a nasogastric tube into the pulmonary tree is a well-recognized complication that can possibly cause a pneumothorax or pulmonary aspiration if feeding was commenced without checking its position before use. This case report describes pneumothorax in a 65-year-old patient following insertion of a nasogastric tube. It also highlights the management of pneumothorax causes by intra-pleural insertion of a nasogastric tube and patients who are susceptible to nasogastric tube complications.
A forgotten nasogastric feeding tube that refuses to get out
Clinical Case Reports, 2017
Nasogastric tubes (NGT) are extensively used and generally harmless, yet loop formation and malpositioning are often reported especially when using thin NGT for enteral feeding which placed blindly; therefore, diligent follow-up of NGT is required with confirmation of right placement, changing it to PEG if long use of NGT needed.
" Nasogastric tube insertion comparison in sitting or supine position-100 cases "
RTF is generally comes use for children or old age. RT insertion is simple and easy method. Nasogastric tube insertion in an unconscious or intubated patients may be difficult as they cannot follow instructions, So many doctors have history of high first attempt failure. The use of nasogastric tube is desirable for some surgical procedures to keep stomach deflated (like laparoscopic surgeries) or for the short term administration of feeds post-operatively. Sometime we needed NGT under vision with help of magill's forcep, Basically NGT insertion is a blind nasal procedure.
Nasogastric Tube Placement- a Simple Yet Difficult Procedure- a Review
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Summary-Despite several novel techniques reported in the literature regarding nasogastric tube placement, no technique has emerged as the most efficient method, especially for unconscious patients. A few of them appears to be achieving higher success rate and considered to be better than the rest. Varied complications have been reported in the literature. We searched for relevant medical literature in English using Google Search Engine. The following Medical Subject Headings (MeSH) terms were used: Decompression, Intubation, Gastrointestinal; Intubation, Intratracheal, Parenteral Nutrition, Stomach. The search was further extended using related keywords such as 'nasogastric intubation,' 'nasogastric tube insertion,' 'nasogastric tube intubation,' 'nasogastric tube placement.' The full text articles published in 2000 onwards were mainly considered with the exception for some old seminal articles. Primarily, original investigations, editorials, letter to Editor and brief communications were consulted. A few review articles were also taken into consideration. A brief outline about nasogastric tubes, its application, confirmatory tests, their current status with loopholes, different method to increase the objectivity of successful placement of nasogastric tube, etc. have been described. Mostly, a general view regarding this has been presented with a mention about the gray zones.
Case Series: Nasogastric (NG) Feeding Tube Misplacement in Critically Ill Tracheostomized Patients
Case Reports in Clinical Medicine, 2020
In this case series we present 3 cases of nasogastric tube misplacement in tracheostomy patients. Although considered safe and it being a common procedure nasogastric tube misplacement can lead to serious and life-threatening complications. We present three cases of nasogastric tube misplacement in tracheostomized patients. One of the cases presented suffered from pneumothorax. Different time intervals between procedures in these different cases resulted in similar results. We would like to emphasize the importance of due conformation of correct placement of the nasogastric tube in the tracheostomy patient as well as to suggest that over inflation of the balloon securing the tracheostomy apparatus in place during nasogastric tube placement, might prevent misplacement. Nasogastric tube placement in tracheostomized patients has potential for serious complications. As such maintaining safe practice procedure is essential. Considering over inflation of the tracheostomy apparatus balloon might be beneficial as well, by preventing entry of NGT into the trachea.
Nutrition in Clinical Practice
The placement of a nasogastric tube (NGT) in a pediatric patient is a common practice that is generally perceived as a benign bedside procedure. There is potential risk for NGT misplacement with each insertion. A misplaced NGT compromises patient safety, increasing the risk for serious and even fatal complications. There is no standardized method for verification of the initial NGT placement or reverification assessment of NGT location prior to use. Measurement of the acidity or pH of the gastric aspirate is the most frequently used evidence-based method to verify NGT placement. The radiograph, when properly obtained and interpreted, is considered the gold standard to verify NGT location. However, the uncertainty regarding cumulative radiation exposure related to radiographs in pediatric patients is a concern. To minimize risk and improve patient safety, there is a need to identify best practice and to standardize care for initial and ongoing NGT location verification. This article provides consensus recommendations for best practice related to NGT location verification in pediatric patients. These consensus recommendations are not intended as absolute policy statements; instead, they are intended to supplement but not replace professional training and judgment. These consensus recommendations have been approved by the American Society for Parental and Enteral Nutrition (ASPEN) Board of Directors.
Nasogastric Tube Placement and Verification in Children: Review of the Current Literature
Nutrition in Clinical Practice, 2014
Placement of a nasogastric enteral access device (NG-EAD), often referred to as a nasogastric tube, is common practice and largely in the domain of nursing care. Most often an NG-EAD is placed at the bedside without radiographic assistance. Correct initial placement and ongoing location verification are the primary challenges surrounding NG-EAD use and have implications for patient safety. Although considered an innocuous procedure, placement of an NG-EAD carries risk of serious and potentially lethal complications. Despite acknowledgment that an abdominal radiograph is the gold standard, other methods of verifying placement location are widely used and have success rates from 80% to 85%. The long-standing challenges surrounding bedside placement of NG-EADs and a practice alert issued by the Child Health Patient Safety Organization on this issue were the stimuli for the conception of The New Opportunities for Verification of Enteral Tube Location Project sponsored by the American Society for Parenteral and Enteral Nutrition. Its mission is to identify and promote best practices with the potential of technology development that will enable accurate determination of NG-EAD placement for both the inpatient and outpatient pediatric populations. This article presents the challenges of bedside NG-EAD placement and ongoing location verification in children through an overview of the current state of the science. It is important for all health care professionals to be knowledgeable about the current literature, to be vigilant for possible complications, and to avoid complacency with NG-EAD placement and ongoing verification of tube location. (Critical Care Nurse. 2014;34[3]:67-78)
Nasogastric tube insertion in anesthetized patients: a comprehensive review
Anestezjologia Intensywna Terapia, 2014
Nasogastric tubes (NGT) still remain the easiest and the best way for gastrointestinal tract access. There are various indications for the insertion of a nasogastric tube in anaesthetized and critically ill patients. Although many techniques have been introduced to facilitate nasogastric tube insertion using anatomic landmarks and a group of devices, there is no consensus on a standard method. Moreover, there are different methods for the assessment of the correct placement of a nasogastric tube. In addition to these challenges in insertion and assessment methods, there are varieties of major life-threatening and minor complications to be addressed. Thus, selecting the most appropriate approach requires enough knowledge in this area, considering patient condition and clinical factors, as well as the practitioners' sufficient education and experience, along with skill in performance. This is a comprehensive review of the literature evidence on different methods for nasogastric tube insertion, on the assessment of correct placement and the evaluation of complications, in addition to an approach to the effect of education on the quality of routine practice and patients' outcome.