1 Nasogastric tubes Background Nasogastric (NG) tubes are placed for a number of medical reasons. These include decompression of the gastrointestinal tract in a patient with intestinal obstruction and for feeding in patients who cannot safely swallow. Traditional methods for confirmation of the position of the tube such as insufflation of gas and pH measurements have been shown to be unreliable, and the gold standard for determining the position of the tip of an NG tube is a CXR. The stakes are high, particularly if the tube has been inserted for the purpose of feeding. If the NG tube does not enter the oesophagus and progress to the stomach, the likely alternative route and destination is the bronchial tree and lung, usually via the more steeply inclined right main bronchus. Introducing a high volume of feed into the lung via such a malpositioned tube can cause pneumonia, and death of patients following this error has occurred. The responsibility for ensuring the position of the tube is correct before feeding often falls upon the on-call junior doctor, who may be asked by a nursing colleague to confirm correct placement. Remember, if you are not sure your senior or radiology colleague is there to help you. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related posts: Chest drains Empyema Chronic pancreatitis Large bowel obstruction Brodie’s abscess Slipped upper femoral epiphysis Stay updated, free articles. Join our Telegram channel Join Tags: On-Call X-Rays Made Easy Aug 20, 2016 | Posted by admin in ULTRASONOGRAPHY | Comments Off on Nasogastric tubes Full access? Get Clinical Tree
1 Nasogastric tubes Background Nasogastric (NG) tubes are placed for a number of medical reasons. These include decompression of the gastrointestinal tract in a patient with intestinal obstruction and for feeding in patients who cannot safely swallow. Traditional methods for confirmation of the position of the tube such as insufflation of gas and pH measurements have been shown to be unreliable, and the gold standard for determining the position of the tip of an NG tube is a CXR. The stakes are high, particularly if the tube has been inserted for the purpose of feeding. If the NG tube does not enter the oesophagus and progress to the stomach, the likely alternative route and destination is the bronchial tree and lung, usually via the more steeply inclined right main bronchus. Introducing a high volume of feed into the lung via such a malpositioned tube can cause pneumonia, and death of patients following this error has occurred. The responsibility for ensuring the position of the tube is correct before feeding often falls upon the on-call junior doctor, who may be asked by a nursing colleague to confirm correct placement. Remember, if you are not sure your senior or radiology colleague is there to help you. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related posts: Chest drains Empyema Chronic pancreatitis Large bowel obstruction Brodie’s abscess Slipped upper femoral epiphysis Stay updated, free articles. Join our Telegram channel Join
