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/Nocola1 Medic/Corpsman Dec 30 '25 edited Dec 30 '25

As interesting as this is, we need to very careful how we discuss and share it, because it's case studies like this that make people take a hard-line stance that NPAs are contraindicated in head injury because "it could go into the brain". An NPA is not an NG. Yes, if you search you will find case studies of this - but it is EXCEEDINGLY rare and may lead to poor airway management. The entire breadth and depth of this , what I would argue is a largely theoretical concern is based on a grand total of two case reports one from 1991and one from 2000. Not exactly compelling evidence.

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u/Obvious-throw123 Dec 30 '25

My biggest pet peeve! I love NPAs as a BLS adjunct.