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.
The ScanCrit manoevre?… Long night shift, K?
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.
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.
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.
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!
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.
Hi
Thanks
Try grabbing the larynx either side and lifting it up (anteriorly) . I call it the “gullet” manoeuvre.
Regards