NGT placement

Specialties Emergency

Published

I would appreciate advice on NGT placement. On a previous shift I placed and NGT tube without difficulty, varified by asculation at the epigastrum and had clear gastric return. The ER doc then requested lavage for blood, which I did, lavaging 250 ml NS and suctioning same amount, no blood. Later the Pt went to CT and it was revealed that the NGT was in the proximal esophagus. How could I have better varified placement?

Specializes in Emergency.
PLEASE HELP!

I had the worst experience inserting an NG tube last year. It was only my second attempt at inserting a NGT. After inserting into the right nare i kept advancing the tube. After being unable to auscultate to ensure proper placement, we ordered an xray. Before t he cxr, we decided to change the babies diaper, upon doing so we realized the tip of the NG tube was protruding throught the orifice! What did I do wrong! :banghead::banghead::banghead::banghead:

you just advanced it too far.....straight through the stomach and jejunum.

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
What did I do wrong! :banghead::banghead::banghead::banghead:

Always measure the tube against the patient first. You should know how far to advance it before doing so.

PLEASE HELP!

I had the worst experience inserting an NG tube last year. It was only my second attempt at inserting a NGT. After inserting into the right nare i kept advancing the tube. After being unable to auscultate to ensure proper placement, we ordered an xray. Before t he cxr, we decided to change the babies diaper, upon doing so we realized the tip of the NG tube was protruding throught the orifice! What did I do wrong! :banghead::banghead::banghead::banghead:

Are you guys sure that this is not an April's Fools joke?

Specializes in ICU, PACU, Cath Lab.

That would be a looooong NGT to make it all the way out the other end...

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

Oh good, so I'm not crazy ... trying to wrap my head around the logistics of that one was difficult. LOL

Specializes in ED, Clinical Documentation.

I just read an email from AACN about NGT placement confirmation that the gold standard is to confirm with a chest xray and pH test. I can't find the email now, but that is also what I recently heard at the NJ ENA conference as well. Hope that helps!

Sara

Are you guys sure that this is not an April's Fools joke?

yeah, it was indeed.

i can just visualize the ngt advancing through that very loopy sm intestines, then colon then through the anal sphincter...:rolleyes:

heh.

brought a smile though.

leslie

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