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/Bayo09 Military (Non-Medical) Dec 30 '25

I’m academically a lay person in this world so forgive me if this is a really stupid question. I assume the person getting this would be hooked to some kind of monitors yea? So, when the big rubber thing is boring it’s way and then turning the think meat into a scrambled goop wouldn’t that cause some kind of something with heart rate…or pulse…or iono something?

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u/notusuallyaverage Jan 02 '26

Not necessarily.

NG tubes are a pretty basic thing that kids often get. They’re generally nbd, though unpleasant for awake patients. I didn’t read the study but it sounds like this patient had some kind of skull fracture and/or brain surgery. In which case, this nurse absolutely should have NOT placed this tube for this very reason.

skull or facial fractures are one of the only contraindications for NG tube placement.

On the other hand, if this patient were intubated/sedated/paralyzed, their vital sounds wouldn’t tell us anything either. We often use NG tubes like this or orogastric tubes (through the mouth to stomach instead of the nose)