OG tube placement and trach tube

[Kate96]

This is probably a dumb question, but I have personally never fully understood why we cannot placed OGs in a patient with a tracheostomy. The trach is placed under the vocal chords in the trachea and the OG is in the esophagus. It is something I know we do not do, but I cannot explain exactly why. I know some patients can eat even with a trach.

Appreciate any feedback or help! Thank! 

[chare]

3 hours ago, Kate96 said:

This is probably a dumb question, but I have personally never fully understood why we cannot placed OGs in a patient with a tracheostomy. ...

No, not a dumb question, and something we occasionally do in the PICU.  I'm curious as to who told you this, and what, if any, rationale that they provided.

[Kate96]

1 hour ago, chare said:

No, not a dumb question, and something we occasionally do in the PICU.  I'm curious as to who told you this, and what, if any, rationale that they provided.

thank you for your response. I have not been provided rational, and I just have never seen a patient with a trach with an OG and I had assumed it is a contraindication. I just spoke to my nurse educator though and he said OG tubes and trachs are not contraindicated, but I think however a lot of our trach patient are relatively conscious and oftentimes because of that reason we do not place OGTs. 

[MaxAttack, BSN, RN]

Never heard of it, either. In my experience if a trach is needed a PEG is likely also going to be placed but of course it varies.

[offlabel]

Why would you want to place an OGT in an adult patient with a trach and not an NGT, assuming an awake patient?

[JuicyJ95, BSN, RN]

I think this comes down to more of a comfort question. If I had a trach and was awake, how obnoxious would it be to have a massive tube going through my mouth, scraping my uvula, etc. In this instance, we would just place a nasogastric tube. I don't think it cannot be done, I just think it shouldn't be done.