C-W Hung1, W-H Lee. 1. Department of Emergency Medicine, Chang Gung Memorial Hospital, 123, Dabi Road, Niausung Shiang, Kaohsiung, 833, Taiwan, ROC.
Abstract
BACKGROUND: It can sometimes be difficult to insert a nasogastric tube (NGT) in a patient in whom intubation has been performed. Because of the patient's inability to swallow and the presence of the inflated cuff of the endotracheal tube, the NGT will often become coiled in the oral cavity. A previous study showed that rigid tubes require fewer insertion attempts than flexible tubes. An attempt was therefore made to increase the rigidity of NGTs by filling the tube with water (water-fill method). The objective of this study was to investigate whether water-filled NGTs would facilitate tube insertion. METHODS: Sixty-six patients intubated with rapid sequence induction in the emergency department were consecutively recruited over a study period of 4 months in 2006. In the first 2 months the patients underwent NGT insertion by the water-fill method (water-fill group) and in the subsequent 2 months NGT insertion was undertaken by the traditional method (control group). Successful NGT insertion for each patient was defined as the passage of the tube in <or=2 attempts. The rate of successful insertion was compared between the two groups. RESULTS: Successful insertions were achieved in 29/31 patients (93.5%) in the water-fill group and in 23/35 patients (65.7%) in the control group. The difference between the two groups was statistically significant (p<0.01). CONCLUSIONS: The water-fill method is a simple and fast method to facilitate NGT insertion in intubated patients.
BACKGROUND: It can sometimes be difficult to insert a nasogastric tube (NGT) in a patient in whom intubation has been performed. Because of the patient's inability to swallow and the presence of the inflated cuff of the endotracheal tube, the NGT will often become coiled in the oral cavity. A previous study showed that rigid tubes require fewer insertion attempts than flexible tubes. An attempt was therefore made to increase the rigidity of NGTs by filling the tube with water (water-fill method). The objective of this study was to investigate whether water-filled NGTs would facilitate tube insertion. METHODS: Sixty-six patients intubated with rapid sequence induction in the emergency department were consecutively recruited over a study period of 4 months in 2006. In the first 2 months the patients underwent NGT insertion by the water-fill method (water-fill group) and in the subsequent 2 months NGT insertion was undertaken by the traditional method (control group). Successful NGT insertion for each patient was defined as the passage of the tube in <or=2 attempts. The rate of successful insertion was compared between the two groups. RESULTS: Successful insertions were achieved in 29/31 patients (93.5%) in the water-fill group and in 23/35 patients (65.7%) in the control group. The difference between the two groups was statistically significant (p<0.01). CONCLUSIONS: The water-fill method is a simple and fast method to facilitate NGT insertion in intubated patients.
Authors: Yiu-Hei Ching; Stephanie M Socias; David J Ciesla; Rachel A Karlnoski; Enrico M Camporesi; Devanand Mangar Journal: SAGE Open Med Date: 2014-03-21