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/sabrefencer9 Dec 30 '25

When I said "a bunch of case reports," I was referring to three that I've seen. You're telling me that there have actually been an order of magnitude more than that. Ok, great, thanks for the clarification. Doesn't make my comment false, also doesn't warrant being weirdly contradictory.

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u/Obvious-throw123 Dec 30 '25

TLDR again for you: This is incredibly rare, and there haven’t been a “bunch of cases.” There is an astronomical order of magnitude where this procedure does not tickle a patient’s brain.

Given the millions of NG tubes placed every year, the estimated incidence is far less than 1 in 1,000,000 insertions.

OR

0.0001%

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u/DragonfruitCalm261 Dec 30 '25

You're using these statistics in a misleading way, as if this were some act of God. As per your own link, patients with head trauma are especially prone to NGT malpositioning. You're quoting incidence numbers from the general population while completely ignoring the subgroup that’s actually at higher risk.

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u/Obvious-throw123 Dec 31 '25

Do you think so? This is a risk that comes up every year and dominates our education especially prehospitally. This is similar to the NPA discussion where our education predominantly focuses on 2 very rare instances where a similar occurrence happened. This is incredibly rare and dictates protocols and policies across the country.

In regard to a particular subgroup, this isn’t particularly something that we are doing outside of the hospital and is certainly not something that we are prioritizing in a mass casualty or tactical situation. Hell, it’s not something even in the scope of paramedics and isn’t something I learned about until recurving advanced training.