hey all!
i have a question for y'all. yesterday i had a patient who needed an ngt to suction the patient before a bronchoscopy. (apparently a ct showed he had stuff to come out). anyway, this patient is not a nice/fun patient as he's been an alcoholic all his life, and it took me 30 min to convince him to have it done. he said it never worked and well i think he may have been right about this.
first i tried and he wouldn't swallow or lean his head forward (it came out his mouth) so i took it out and and called a senior nurse to do it. she was firm with and made sure he swallowed and kept his head forward and it seemed to work. i was skeptical because the only thing i could aspirate was small amounts of slimy, clear liquid making me concerned it wasn't in the stomach. i didn't hear "swooshing" with the auscultatory method of checking placement either. i called the charge nurse finally and she didn't think it was in the stomach. so, she took it out and reinserted it. still getting the same secretions. she seemed happy but i still was not sure. finally the pulmonary fellow came and thought it was strange no secretions were being suctioned out. him and i were with the patient for like 20 min and he was listening while insufflating air...the doctor thought it might no be in the stomach yet which i suspected..he moved it around. finally we got more secretions but still clear (wouldn't we see some stomach acid?) anyway, finally we took it out since his stomach wasn't distended. the doc thought it might have gotten coiled in the back of his throat but then he thought had finally got it into his stomach. i had measured it and we went it way far, farther than necessary to reach a normal stomach.
thanks for not falling asleep yet. my question is, how do you make sure the ngt makes it to the stomach? it seemed to coil in this guy, come out his mouth. and i got so behind trying to figure out what was going on and only getting slimy, clear stuff and i had two senior nurses help me. is there any secrets you can tell me? one nurse said to put the ngt tube in ice to make it stiff to go down easier. please help!