Passing the orogastric tube can be difficult or sometimes impossible. Unfortunately a lot of patients really need their OGs and in a time-critical scenario you don’t want to spend too much time struggling with it. Here is a simple trick a senior colleague showed me. Many of you probably already know of this technique and may already be doing it. My colleague says he has been doing this since back in the seventies. I find that hard to believe as he was born in the late 1960s.
Anyway, the idea is to intubate the oesophagus with a large ET-tube and then to use the ETT as an introducer to railroad the OG-tube down the oesophagus.
Here’s how to do it:
Prepare an large ET tube by cutting away the cuff balloon and removing the connector part.
Cut the tube down the middle.
Intubate the oesophagus with the cut ETT. Blindly or with a laryngoscope. As any EM-registrar can tell you, intubating the oesophagus with an ET tube is super easy.
Railroad the OG tube down the cut ET tube, down the oesophagus and into the ventricle.
Separate the OG and ET tubes by pushing the OG through the cut ETT side. Remove the ETT while the OG stays in place.
Naturally, I wanted to claim this technique as my own invention with a formal write-up. Unfortunately, as always in my case…, someone already published it. 🙁
A blog on anaesthesia, intensive care and emergency medicine. In-hospital and outside. Mostly focusing on the critically ill patient. Written by two Scandinavian senior anaesthetic registrars turned consultants.
This is our way of keeping log of articles and interesting things we come across in our work and on the internet. Should any of you out there stumble across this blog and find it useful then all the better.
Please leave comments or questions if you have any. The best way to keep learning is to keep the conversation going.