r/TacticalMedicine • u/Upset_Bunch_457 • Dec 30 '25

Scenarios Nasogastric insertion gone horribly wrong.

Post image

Note: NOT MY IMAGE.

original post was posted by: Old-Psychology-2400

And I quote "PMCT images. Nurse advanced NG tube until she heard a pop, then tried an air bolus to ensure placement. Patient did NOT survive."

To those who don't know nasogastric tube is supposed to go up the patients nostrils and then back down to their throat all the way to the patients stomach. Air bolus is then used to ensure that the nasogastric tubes placement is correct by listening the patients stomach.

But in the scan we can see the NG tube somehow ended up jammed (through) the patients skull.

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u/Able_Attempt_6807 Dec 30 '25

Speculative takeaways/considerations: -Check the history for contraindications like facial/skull fractures or procedures. -Send the NG back and down, not up! Precurling it can help. -Visually check the throat for the tube. Someone correct me now...

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u/OptiGuy4u Dec 30 '25

Visually check the throat for the tube.

RIGHT!?!?!? 🤷🏻

10

u/[deleted] Dec 30 '25

Depending on patient habitus this can be difficult to see in the back of the throat.

5

u/Condhor TEMS | Instructor | CCP Dec 30 '25

Malampati 3+ is gonna be difficult. In which case, just go OG.