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      Cervical Subcutaneous Emphysema following Total Laryngectomy: An Unusual Complication of Nasogastric Intubation

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          Abstract

          The nasogastric tube remains an important route of enteral feeding in the early postoperative period following total laryngectomy. Its insertion, however, is not without any risks of complications. In this article, we report an unusual case of inadvertent nasopharyngeal perforation secondary to intraoperative nasogastric tube insertion presenting as unilateral cervical subcutaneous emphysema in a patient who underwent total laryngectomy.

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          Thoracic complications of nasogastric tube: review of safe practice.

          Stephanie Brister, Jay J Pillai, Annette Vegas (2005)
          Insertion of a nasogastric tube, though a common clinical procedure, can produce unexpected complications. We sought to analyse the procedure, and explore means to improve its safety. We present a case with a thoracic complication. We review the English literature for the range of complications, and collate all available clinical tests used to confirm enteric placement. We discuss the short-comings of the usual clinical tests and emphasise the more recent, but less mainstream, procedures that introduce more objectivity to the enteric tube placement. We provide summary points to guide the clinician in everyday practice.
          Article 0 comments Cited 38 times – based on 0 reviews     Review now
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            A New Technique to Insert Nasogastric Tube in an Unconscious Intubated Patient

            Tanmoy Ghatak, Sukhen Samanta, Arvind Baronia (2013)
            Background: Insertion of a nasogastric tube in an unconscious intubated patient may be difficult as they cannot follow the swallowing instructions, and therefore has a high first attempt failure rate. Aim and Methods: We describe here a new technique to insert nasogastric tube in an unconscious intubated patient by neck flexion and using angiography catheter as a stylet and manipulating the cricoid ring of trachea for easy passage of nasogastric tube. Results and Conclusions: The technique is easy and helpful for nasogastric insertion in unconscious intubated patients. Additionally, it neither alters vital responses nor increases intracranial pressure like with laryngoscopy.
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              Patient safety matters: reducing the risks of nasogastric tubes.

              Sylva Donaldson, Iain Yardley (2010)
              Nasogastric tube insertion is a common clinical procedure carried out by doctors and nurses in NHS hospitals daily. For the last 30 years, there have been reports in the medical literature of deaths and other harm resulting from misplaced nasogastric tubes, most commonly associated with feed entering the pulmonary system. In 2005 the National Patient Safety Agency in England assembled reports of 11 deaths and one incident of serious harm from wrong insertion of nasogastric tubes over a two-year period. The agency issued a safety alert setting out evidence-based practice for checking tube placement. In the two and a half years following this alert the problem persisted with a further five deaths and six instances of serious harm due to nasogastric tube misplacement. This is a potentially preventable error but safety alerts advocating best practice do not appear to reliably reduce risk. Alternative solutions, such as standardising procedures, may be more effective.
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                Author and article information

                Contributors
                Guled M. Jama:
                ORCID: https://orcid.org/0000-0002-0705-607X
                Journal
                Journal ID (nlm-ta): Case Rep Otolaryngol
                Journal ID (iso-abbrev): Case Rep Otolaryngol
                Journal ID (publisher-id): CRIOT
                Title: Case Reports in Otolaryngology
                Publisher: Hindawi
                ISSN (Print): 2090-6765
                ISSN (Electronic): 2090-6773
                Publication date Collection: 2019
                Publication date (Electronic): 7 July 2019
                Volume: 2019
                Electronic Location Identifier: 2712481
                Affiliations
                1Department of ENT, New Cross Hospital, Wolverhampton WV10 0QP, UK
                2Department of Radiology, New Cross Hospital, Wolverhampton WV10 0QP, UK
                Author notes

                Academic Editor: Kamal Morshed

                Author information
                https://orcid.org/0000-0002-0705-607X
                Article
                DOI: 10.1155/2019/2712481
                PMC ID: 6642750
                SO-VID: 8935e62f-1070-4479-b7a0-d1d8d8495739
                Copyright © Copyright © 2019 Guled M. Jama et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 4 January 2019
                Date accepted : 2 July 2019
                Categories
                Subject: Case Report

                Data availability:

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