Application of Modified Gastric Tube Placement in Patients with Indwelling Gastric Tube

Objective: To explore the effect of modified nasogastric tube placement and Rehabilitation New Liquid Spray in patients with indwelling gastric tube. Methods: Eighty-six cases with indwelling gastric tube in our hospital from January 2020 to May 2021 were randomly selected and divided into the reference group and the research group. The reference group was treated by modified gastric tube placement, and the research group was given the Rehabilitation New Liquid Spray intervention. The effect of the interventions on two groups was observed. Results: The incidence of nasal mucosal injury in the research group was lower than that in the reference group, and the incidence of pharyngeal mucosal injury in the research group was lower than that in the reference group (P < 0.05). The pain score of the study group was lower than that of the reference group at 8 h, 12 h and 24 h after replacement, and the incidence of hoarseness, swallowing discomfort and dry oropharynx was lower than that of the reference group (P < 0.05). Conclusion: The application of modified gastric tube placement and Rehabilitation New Liquid Spray intervention in patients with indwelling gastric tube can effectively reduce the nasopharyngeal injury and improve the pain of catheterization.

Nasogastric Tube Placement: A Cross-Comparison of Verification Methods Used in Pennsylvania Hospitals and How They Align With Guidelines

Nasogastric tubes (NGTs) are used as an alternative approach to deliver nutrition and medications, or a method to remove stomach contents. Insertion of these tubes is considered a simple procedure; however, wrong placement or dislodged tubes can lead to patient harm and possibly death. The risk of harm and death increases when misplaced or dislodged tubes are not identified prior to using them. We queried the Pennsylvania Patient Safety Reporting System for events that occurred between January 1, 2017, and June 30, 2020. We analyzed those reports that provided supplemental information describing NGT placement verification methods to determine how these activities aligned with NGT guidelines. The use of X-rays and pH aspirate, guideline-approved verification methods, were identified in 90.8% (544 of 599) of the reports. In 9.2% (55 of 599) of the reports, the use of non-recommended verification methods (e.g., insertion of air bolus/auscultation, were identified). Reports indicated that patients aged less than one year old experienced a higher percentage of non-recommended verification methods being used when compared to all other patients. Interviews with staff at three healthcare facilities discussed their approach to verifying NGT placement. Risk reduction strategies comprise using the guideline recommendations to verify NGT placement and avoiding the use of non-recommended verification methods.

Endoscopic Evaluation for Stricture Formation Post Button Battery Ingestion

Every year, there are over 3300 ingestions of button batteries, mostly by young children. Initial presentation of button battery ingestion may be nonspecific, with a delay in diagnosis and removal resulting in increased risk of complications. We present the case of a five-year-old female who presented with vomiting following unwitnessed button battery ingestion. The battery was impacted in the middle esophagus for at least six hours. Endoscopy was performed for immediate removal and showed a Grade 2B erosion, warranting nasogastric tube placement. The patient remained asymptomatic following discharge and had a barium swallow that was read as normal. However, a repeat endoscopy one month later visualized stricture formation at the previous battery injury site. This case highlights the importance of both clinician and parent awareness of button battery ingestion and demonstrates that endoscopy provides the most accurate assessment of esophageal injury and complication development, even in asymptomatic patients.