Gastric tubes are commonly used in both the pre-hospital and hospital environment for a variety of reasons. Depending on the patient and/or provider, these range from orogastric to nasogastric in nature. In this podcast episode, we raise the question, “Does it matter which one we choose?” Tune in as we discuss gastric tubes in general, indications, contraindications, and why you should choose OG over NG whenever possible. We also feature a video demonstrating how to introduce an OG tube when inserting by conventional methods is difficult.
Sengstaken–Blakemore tube:
Introducing the OG Tube:
Adeyemo, A. A., Fasunla, A. J., Adeosun, A. A., & Abdullahi, H. (2007). Rhinosinusitis; A Potential Hazard of Nasogastric Tube Insertion. Annals of Ibadan Postgraduate Medicine,5(1), 44-45. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110988.
Kwon, O. S., Cho, G. C., Jo, C. H., & Cho, Y. S. (2015). Endotracheal tube-assisted orogastric tube insertion in intubated patients in an ED. The American Journal of Emergency Medicine, 33(2), 177-180. Retrieved from https://www.ajemjournal.com/article/S0735-6757(14)00793-1/fulltext.
Lee, X., Yeh, L., Jin, Y., Chen, C., Lee, M., & Huang, P. (2017). Nasogastric tube placement with video-guided laryngoscope: A manikin simulator study. Journal of the Chinese Medical Association, 80(8), 492-497. Retrieved from https://www.ncbi.nlm.nih.gov/m/pubmed/28601629/.
Prabhakaran, S., Doraiswamy, V. A., Nagaraja, V., Cipolla, J., Ofurum, U., Evans, D. C., . . . Kavuturu, S. (2012). Nasoenteric tube complications. Scandinavian Journal of Surgery,101, 147-155.
Vassar, C., & Gee, C. (2004). Nasogastric and orogastric tube management. Retrieved from https://www.gosh.nhs.uk/health-professionals/clinical-guidelines/nasogastric-and-orogastric-tube-management
Willette, P. (2017, February 10). Trick of the Trade: Rapid Insertion of OG Tube. Retrieved from https://www.aliem.com/2017/02/trick-rapid-insertion-orogastric-tube/
Sorry for the very late comment on this episode; I recently discovered this resource and have been going through some of the old ones. I appreciate your coverage of this topic. Certainly, this one has minimal sex appeal (and will never be covered on something like EMCRIT), but I hope you’ll find other similar subjects to explore.
Good points on the significance of sinusitis and the potential of a NG tube as a source of fever. Marino’s ICU Book spends a few pages on this- it’s worth a read for any interested parties.
As I see it, the brilliance of a topic like this is that it’s very common and can be improved with minimal effort or practice change. If we’re able to analyze all of the seemingly “small things” we do at the bedside, barely measurable improvements in each of them can culminate in better outcomes.
Thanks for your efforts with this. I’m looking forward to more.
Cheers.
It CAN be sexy depending on your perspective, but you’re right. We try to cover topics no one else has spent time on. We’re glad you found this resource beneficial.