Korean J Crit Care Med.  2013 Nov;28(4):287-292. 10.4266/kjccm.2013.28.4.287.

Guidewire-Assisted Nasogastric Tube Insertion in Intubated Patients in an Emergency Center

• Go J
• Kim H
• Kim S
• You JS
• Kim MJ
• Chung HS
• Chung SP
• Lee HS

• KMID: 1977505
• DOI: http://doi.org/10.4266/kjccm.2013.28.4.287

Abstract

BACKGROUND
The purpose of this study is to identify the usefulness of guidewire-assisted nasogastric tube insertion in intubated patients with cervical spine immobilization or unstable vital signs in an emergency center.
METHODS
Thirty-four intubated patients in an emergency center were enrolled in the study. Patients were randomly allocated to the control group or the guidewire group. All patient necks were kept in neutral position during the procedure. In the control group, the nasogastric tube was inserted with the conventional method. A guidewire-supporting nasogastric tube was used in the guidewire group. The success rates of the first attempts and overall were recorded along with complications.
RESULTS
The first attempt success rate was 88.2% in the guidewire group compared with 35.2% in the control group (p < 0.001). The overall success rate was 94.2% in the guidewire group and 52.9% in the control group (p = 0.017). Five cases of self-limiting nasal bleeding were reported in the guidewire group, and two cases occurred in the control group. No statistical differences were identified between groups.
CONCLUSIONS
Guidewire-assisted nasogastric tube insertion is a simple and useful method in intubated patients with cervical spine immobilization or unstable vital signs.

Keyword

guidewire; intubation; nasogastric tube

MeSH Terms

Emergencies*
Epistaxis
Humans
Immobilization
Intubation
Neck
Spine
Vital Signs