Methods and Complications of Nasoenteral Intubation

Halloran, Owen; Grecu, Bianca; Sinha, Ashish

doi:10.1177/0148607110370976

Cited by 58 publications

(66 citation statements)

References 97 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Altered mental status, preexisting endotracheal tube, and critical illness place patients at higher risk for malposition. 7 The seemingly small percentage of complications from malpositioned tubes (1%-2%) affects an underappreciated number of patients, bearing in mind that 1.2 million small-bowel feeding tubes are placed annually in the United States alone.…”

Section: Discussionmentioning

confidence: 99%

Verifying Placement of Small-Bore Feeding Tubes: Electromagnetic Device Images Versus Abdominal Radiographs

Bryant

Phang

Abrams

2015

American Journal of Critical Care

View full text Add to dashboard Cite

Background Clinicians are unsure if radiography is needed to confirm correct positioning of feeding tubes inserted with assistance from an electromagnetic system. Objectives To compare radiographic reports of feeding tube placement with images generated by an electromagnetic feeding tube placement device. Methods The medical records of 200 consecutive patients who had feeding tubes inserted with assistance from an electromagnetic feeding tube placement device were reviewed retrospectively. Radiographic reports of tube site were compared with images generated by the device. Results Radiographic evidence of tube sites was available in 188 cases: 184 tubes were located in portions of the gastrointestinal tract. Ninety of the 188 tubes were situated in the optimal site (distal duodenum or jejunum) radiographically. Images generated by the electromagnetic device were available in 176 cases; of these, 52 tubes appeared to end in the expected left lower quadrant. Tubes shown on radiographs to be in other sites also occasionally appeared to end in the left lower quadrant. Nurses using the device did not recognize 4 of the 188 tubes (2.1%) that were inadvertently placed in the lung. No consistent pattern of quadrant distribution was found for tubes positioned in the stomach or proximal duodenum. Conclusions Images generated by the electromagnetic tube placement device provided inconsistent results regarding tube location. A small percentage of seriously malpositioned tubes were not detected by using the electromagnetic device. These findings do not support eliminating radiographs to confirm correct tube placement following use of an electromagnetic tube placement device.

show abstract

Section: Discussionmentioning

confidence: 99%

Verifying Placement of Small-Bore Feeding Tubes: Electromagnetic Device Images Versus Abdominal Radiographs

Bryant

Phang

Abrams

2015

American Journal of Critical Care

View full text Add to dashboard Cite

show abstract

“…Introduction of nasogastric feeding tubes is usually blindly performed and is considered a safe, easy, non-expensive procedure in awake patients [1]. The rate of complications of a blind insertion technique varies from 0.3 to 15% [1] and is usually related to inadvertent insertion of nasogastric tubes into the trachea and distal airways.…”

Section: Discussionmentioning

confidence: 99%

“…The rate of complications of a blind insertion technique varies from 0.3 to 15% [1] and is usually related to inadvertent insertion of nasogastric tubes into the trachea and distal airways. Severe aspiration pneumonia, hydrothorax, hemothorax, empyema and delayed pneumothorax have been described as complications [2][3][4][5].…”

Section: Discussionmentioning

confidence: 99%

The Real Risks of Nasogastric Tubes: "Nutrothorax" Complicating a Misplaced Nasogastric Feeding

Alonso¹

2016

Clin Med Img Lib

View full text Add to dashboard Cite

“…[5][6][7][8] Halloran et al 9 estimated that more than 1 million NG-EADs are placed annually in adults. However, the number of NG-EADs placed and used in children and the frequency of placement errors is not known.…”

Section: Introductionmentioning

confidence: 99%

“…14 In this article, we specifically refer to NG-EAD placement for simplicity, with the inherent understanding that orogastric EADs carry similar risks to patient safety. 9 The placement and use of an NG-EAD presents 2 issues of concern that have important implications for patient safety: (1) the achievement of correct initial NG-EAD placement and (2) ongoing verification for correct NG-EAD location. Despite the routine nature of their use, errors in NG-EAD placement and difficulties with ongoing location verification continue to exist and are reported with varying frequency, making it difficult to quantify the incidence of placement errors and failures in ongoing maintenance of correct location.…”

Section: Introductionmentioning

confidence: 99%

Nasogastric Tube Placement and Verification in Children: Review of the Current Literature

Irving¹,

Lyman

Northington

et al. 2014

Critical Care Nurse

View full text Add to dashboard Cite

Placement of a nasogastric enteral access device (NG-EAD), often referred to as a nasogastric tube, is common practice and largely in the domain of nursing care. Most often an NG-EAD is placed at the bedside without radiographic assistance. Correct initial placement and ongoing location verification are the primary challenges surrounding NG-EAD use and have implications for patient safety. Although considered an innocuous procedure, placement of an NG-EAD carries risk of serious and potentially lethal complications. Despite acknowledgment that an abdominal radiograph is the gold standard, other methods of verifying placement location are widely used and have success rates from 80% to 85%. The long-standing challenges surrounding bedside placement of NG-EADs and a practice alert issued by the Child Health Patient Safety Organization on this issue were the stimuli for the conception of The New Opportunities for Verification of Enteral Tube Location Project sponsored by the American Society for Parenteral and Enteral Nutrition. Its mission is to identify and promote best practices with the potential of technology development that will enable accurate determination of NG-EAD placement for both the inpatient and outpatient pediatric populations. This article presents the challenges of bedside NG-EAD placement and ongoing location verification in children through an overview of the current state of the science. It is important for all health care professionals to be knowledgeable about the current literature, to be vigilant for possible complications, and to avoid complacency with NG-EAD placement and ongoing verification of tube location.

show abstract

Methods and Complications of Nasoenteral Intubation

Cited by 58 publications

References 97 publications

Verifying Placement of Small-Bore Feeding Tubes: Electromagnetic Device Images Versus Abdominal Radiographs

Verifying Placement of Small-Bore Feeding Tubes: Electromagnetic Device Images Versus Abdominal Radiographs

The Real Risks of Nasogastric Tubes: "Nutrothorax" Complicating a Misplaced Nasogastric Feeding

Nasogastric Tube Placement and Verification in Children: Review of the Current Literature

Contact Info

Product

Resources

About