TABLE 852 Techniques for Identifying Nasogastric and Nasointestinal Feeding Tube Placement

Placement of the NG tube into the respiratory tract can result in pneumonia or pneumothorax. If charcoal is instilled, the outcome can be fatal. While not the standard of care, chest radiographs may aid in the confirmation of NG placement prior to instilling charcoal or other medications. If the tube is identified in the chest cavity, it must be determined whether it entered through the lungs or through the esophagus. All possible charcoal should be removed by suctioning prior to removing the NG tube or, in the case of charcoal thorax, by chest tube drainage.

There are numerous reports of intracranial placement of NG tubes.2 Most cases have been reported in trauma patients; however, there is at least one report of intracranial placement in a nontrauma patient.3 As with any catheter insertion, force should never be used, and nasogastric tubes should be inserted through the mouth in trauma patients who may have facial or basilar skull fractures. Any time a NG tube is placed and cannot be easily removed, an x-ray should be obtained to determine the location of the tube.

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