To Be or Knot to Be: A Rare Case of Nasogastric Tube Knotting

Nasogastric intubation is a frequent practice in clinical care used for administering enteral feed, gastric decompression, and lavage. The knotting of a nasogastric tube is a rare complication with only a few incidences of narrow bore nasogastric tube knotting and even fewer wide-bore tubes reported [1-4]. Unrecognized knotting of the nasogastric tube with inadvertent removal may cause catastrophic consequences like epistaxis, respiratory distress’ severe laryngeal injury, and tracheoesophageal fistula [5-7]. Tubes have been found to be kinked and less commonly knotted. Cases of knotting have previously been identified during insertion or blockage of the tubes post-insertion. Ours is a case of nasogastric tube knotting identified in a young patient with a working tube that knotted over itself during removal.

Comparison of Using Cold Versus Regular Temperature Tube on Successful Nasogastric Intubation for Patients in Toxicology Emergency Department: a Randomized Clinical Trial

Introduction: In view of the contradictory results for the use of cold tubes for the purpose of enhancing nasogastric tube insertion success there is a pressing need for further research in this area. This study aimed to determine the effect of using cold versus regular temperature nasogastric tube on successful nasogastric tube insertion for patients referring to toxicology emergency department. Methods: This study is a clinical trial with two groups design of 65 patients admitted to toxicology emergency department who were divided into two groups by random allocation. Nasogastric tubes used in the intervention group had been stored in a refrigerator at 2°-8° C while the ones employed in the control group had been maintained at the room temperature of 22-28° C. Nasogastric tube insertions in both groups were done by the investigator according to standard methods. The data were analyzed using SPSS ver. 13. Results: The placement of nasogastric tube was done in the first attempt with 27 (%84.4) of the subjects in the control group and 33 (%100.0) in the intervention group. The chi-square test results showed that the frequency of the number of attempts for gastric intubation in subjects between the two groups was statistically significant. Conclusion: Cooling gastric tubes reduces the time required for nasogastric intubation. Thus, it is suggested that the gastric tubes be cooled before the application of the procedure so as to reduce complications, increase patient comfort and save nurses time.