Feeding nasogastric tubes into the oesophagus can in some sedated or comatose patient’s be surprisingly hard or even impossible. One method I found works almost every time is reaching deep into the intubated patient´s mouth with two fingers.

That way you can feel the NG-tube entering the nasopharynx on the top of your fingertips. Then, using your fingers, you can often guide the NG-tube into the oesophagus. Instead of it just curling up in the patient’s mouth.

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  1. Thomas D says:

    The ScanCrit manoevre?… Long night shift, K?

    • K says:

      Hmmm….I might have lost perspective in the wee hours of the morning.

      Still, while I no longer claim having invented this method, I take great pride in having discovered it´s eponymous name.

  2. Casey says:

    Or you find the most enthusiastic med student and ask them to ” intubate now, quick, put pressure on them….”
    Then just slide the NG tube down the ETTA – guaranteed to be in the orsophagus 99% of the time.

    • K says:

      Casey, interesting method. But why not hand them ´the special tube´to begin with. That way they will intubate the ´trachea´ with a NG-tube and you don´t have to bother with swapping tubes.

      Having said that, I have had a few´capnograph malfunctions´ myself that were resolved by reintubating.

  3. Driver Robbie says:

    Thanks, I’ll try this one out . Nothing fills me with more frustration than the fruitless battle with a gastric tube that refuses to go where it is told!

  4. Andy Neill says:

    When I used to do ICU, someone showed me to do this – really useful tip. We also kept NG tubes in the fridge so that they retained their stiffness a bit longer.

  5. Sa'ad Lahri says:

    Try grabbing the larynx either side and lifting it up (anteriorly) . I call it the “gullet” manoeuvre.


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