Insertion of the Nasogastric Tube Made Easy

Nasogastric tube insertion in anaesthetized patients: a comprehensive review

“…The routine way for NGT insertion is its blind insertion while the patients head is in the neutral position with an approximate success rate of 40-58% [17][18][19]. Although common techniques for NGT insertion are lateral neck pressure, head flexion, freezing the NGT before its insertion, anterior larynx displacement, slit ETT as introducer, as well as lateral head positioning, none of them has reported high success rate [17][18][19][20][21] (Table 1). For the first time, Siegel et al showed that a nasopharyngeally placed endotracheal tube could facilitate the insertion of a difficult nasogastric tube [55].…”

“…org/nasogastric-tube-insertion-the-simple-yet-impossible/ accessed 11 Nov 2016). Table 2 shows different RCTs concering NGT insertion methods [62][63][64][65][66][67][68][69][70][71][72][73][74][75].…”

A case of tracheal tube cuff failure

“…Insertion of a gastric tube can be a difficult and frustrating experience, especially in patients who are anesthetised, paralysed and sedated [1][2][3][4][5][6][7]. Ozer and Benumof [8] have found that the most common sites of impaction of orogastric and nasogastric tubes are the pyriform sinuses and arytenoids cartilages, leading to coiling in the oropharynx.…”

“…Use of gum elastic bougie, Magill's forceps, endoscopy biopsy forceps and digital assistance have been described for this purpose [2][3][4][5][6].…”

“…Literature review revealed cases of pilot balloon malfunction on other makes of tube [1][2][3] and a case in a Portex type tracheal tube due to an elliptical defect in the wall of the ETT, that was at the level of the notch cut for the insertion of the pilot tube [4]. These other cases also had the pilot balloon dysfunction at the junction of the pilot tube to the tracheal tube, but there was no mention of the pressure at which the leak appeared.…”