tailieunhanh - Báo cáo y học: " Nasogastric tube incidents and the use of the ‘whoosh test"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Nasogastric tube incidents and the use of the ‘whoosh test’. | Available online http content 11 4 419 Letter Nasogastric tube incidents and the use of the whoosh test James Dawson Department of Anaesthetics and Critical Care Nottingham University Hospitals NHS Trust Queen s Medical Centre Campus Derby Road Nottingham NG7 2UH Corresponding author James Dawson james@ Published 9 August 2007 This article is online at http content 11 4 419 2007 BioMed Central Ltd Critical Care 2007 11 419 doi cc6083 Having just read the April edition of the Patient Safety Bulletin from the National Patient Safety Agency 1 I have issue with an article on nasogastric tube NGT incidents and the use of the whoosh test in checking NGT placement in intensive therapy unit patients. The whoosh test is undertaken by rapidly injecting air down an NGT while auscultating over the epigastrium. Gurgling is indicative of air entering the stomach whilst its absence suggests the tip of the NGT is elsewhere lung oesophagus pharynx and so on . The article 1 and an associated guideline 2 outlaws totally the use of the whoosh test. If an aspirate is not obtainable once the NGT is sited performing the whoosh test is a valuable means to assess the likelihood of the NGT being in the stomach or not. If a positive whoosh test is heard then a chest radiograph CXR can be requested. If the whoosh test is negative then there is little point in requesting a CXR as the probability of the NGT being in the stomach is very low in my experience . Performing an unnecessary CXR on an intensive therapy unit patient carries risks of radiation to patient adjacent patients and staff of unnecessary rolling in patients with potential spinal injuries and of unnecessary use of intensive therapy unit and radiology staff time and resources. The whoosh test should never be used in isolation to ascertain if an NGT is in the stomach. As a screening tool prior to CXR however the test is invaluable should an aspirate be unobtainable Competing interests The

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