Inserting an NG tube post arrest

[abidingpanda]

I am a new nurse and I work in the emergency department. One of the things we do at my facility with a post arrest after we RSI the pt, establish IV access, and start drips is insertion of an NG tube. I cannot seem to figure out how to get the tube in to the stomach on an unconscious pt!!! I have no issues when the pt is alert, sitting up, and sipping water, but the tube coils in their mouth every time if they're unconscious. I've tried bringing the chin to the chest, and leaving the pt's head flat on the cot, and 9/10 times it coils in places besides the stomach. I have also tried using more lube, smaller tubes, and different nares. Any tips?

[blondy2061h, MSN, RN]

They're not fed when they're cold, that's true. But most post arrests when warmed are then fed as we play the "will they/won't they" game in regards to trach/PEG. OGTs can also be used for med administration.

Although...ENT placing PEG? We always had general surgery come to the unit and do it at the same time as the trach.

ENT does our trachs and its become very common for patients to get a PEG simultaneously, so ENT has started doing both.

My comment was tongue in cheek. By the time someone has been vented long enough to need a trach they're being fed, someway, somehow, I hope. I know they're not being fed immediately post arrest.

[bebbercorn]

I second all of the above, I actually can't remember ever putting in an NGT on an intubated pt, I've always gone straight for OG.

[hawaiicarl, BSN, RN]

1. Use an 18Fr tube, the smaller the tube the higher the chance it will coil.

2. Get a cup of ice water, and soak the tip of the tube in it for a few seconds, or aspirate some water into the tube with a syringe. Then curve the tip downward to assist passing the back of the pharynx.

Cheers

[Penelope_Pitstop, BSN, RN]

Yes, I confronted a false statement addressed to me with a fact. Not to provoke an argument but to prevent one.

I wasn't going to argue with you at all! Goodness, I just pointed out that post arrests ARE fed via OGT usually if care is to be continued but prior to trach/PEG time.

I'm sorry I didn't quote blondy! I was merely asking a question and wasn't arguing with her, either. I just thought ENTs placing PEGs was weird!