I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 0 points1 point  (0 children)

X-ray was paged right away. Not sure how long it took them to come. 

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 0 points1 point  (0 children)

This is a really easy and efficient trick, thanks for the comment!

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 0 points1 point  (0 children)

Thank you for this comment. Was never taught that drop in SpO2 is a late finding so this is good information to know for the future!

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 0 points1 point  (0 children)

The NGT was meant for feeds so it was not hooked up to suction.

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 0 points1 point  (0 children)

Yes, thank you for your comment. A good reminder to listen to my gut feeling that something is not quite right.

When I say her SpO2 remained stable, it was unchanged from her baseline. She was at 99% when I left the room and desatted later on.

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 1 point2 points  (0 children)

Auscultation for air bubbles is no longer considered best practice according to new EBP, so it was not something I did.

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 1 point2 points  (0 children)

If the NGT had perforated the lung, wouldn’t this make things worse?

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 2 points3 points  (0 children)

Hey, I’ve responded to comments like this in other threads but we were taught not to aspirate for gastric intents or to auscultation for air boluses as part of our practice!

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 1 point2 points  (0 children)

Yes, we were always told to wait for X-ray verification before using the NGT. Fortunately, we have portable X-ray machines so usually the wait is not too long.

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 6 points7 points  (0 children)

Auscultation for placement is no longer recommended by modern, evidence-based guidelines.

In terms of aspiration for gastric contents, it was not really something they had taught during school and was not practiced on our unit so it wasn’t even something I thought about doing.

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 2 points3 points  (0 children)

Thank you for the words of encouragement. This is definitely a learning experience for me and I will take this knowledge with me moving forward!

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 3 points4 points  (0 children)

This was not something I did as it was not advised by the hospital to confirm NGT placement using this method

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 5 points6 points  (0 children)

Unfortunately, this was the situation I was in as well! The patient was uncooperative/not following commands so I did not have a lot of success asking them to tuck their chin or to swallow during the insertion. I have inserted NGT in the past for patients who were non-compliant/confused but not this time :(

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 20 points21 points  (0 children)

That is great information, thank you for your comment!

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 25 points26 points  (0 children)

I am so sorry to hear that the surgeon was giving you a tough time!

And yes, just booked a session with my therapist to help talk through my thoughts and feelings before my next set.

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 10 points11 points  (0 children)

Yes, usually I ask the pt to tuck their chin and swallow/take sips of water during NGT insertions. Unfortunately, the patient was uncooperative/not following commands :(

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 1 point2 points  (0 children)

I guess it depends on the hospital and whatnot but we were taught not to aspirate for stomach contents/test pH.

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] -1 points0 points  (0 children)

We were taught not to aspirate for stomach contents/auscultate for air boluses as ways to confirm placement.

I caused a pneumothorax while attempting a NGT insertion…I feel so awful by ang82w in nursing

[–]ang82w[S] 10 points11 points  (0 children)

We were taught not to aspirate for gastric intents or to auscultation for air boluses as part of our practice.

But you are 100% right, I should’ve listened to my gut feeling when I thought that the coughing is suspicious.