When Bad Things Happen to Good NGs
I always knew I hated NG tubes, but I thought it was simply because I’d probably punch someone in the face if they tried to shove something up my nose, down my throat and into my stomach. But now I really know why I hate them…because they can be really scary when you realize the things that can go wrong with them.
I was at a staff meeting today, and we were talking about how it’s unreliable to use auscultation to confirm NG placement. In the midst of this, our educator says something along the lines of, “You know…it can go in the lungs or the brain.”
THE BRAIN???
The lungs I knew about, worried about, obsessed about. But now I have to worry about the brain, too? So, of course, I did what any curious person does in this day and age…I googled it. And what I saw gave me something else to worry about: http://www.impactednurse.com/?p=2235.
Apparently this patient had a congenital abnormality that created a pathway from the nasal cavity up into her brain…how she didn’t die of overwhelming infection prior to this is anyone’s guess. However, though extremely extremely rare, these things CAN happen. Just another reminder of the immense responsibility nurses face and how we cannot ever let even the most everyday task become routine. Though the clinical environment is, at times, highly chaotic, we have to remind ourselves to stay in the moment and focus on what we’re doing each and every time.
And always, always get that chest x-ray to confirm placement!
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