- Joined
- Jan 1, 2007
- Messages
- 4,826
- Reaction score
- 492
We had a very unfortunate case recently where a patient died of aspiration after an attempted NG tube placement. The events leading up to the aspiration caused a lot of discussion at our M&M.
The patient clearly had an ileus and was vomiting and needed an NG tube. We asked the nurse to try, then the charge nurse when that wasn't successful. At this point we considered consulting general surgery for the NG tube placement, as none of us (urology residents) had any significant experience placing NG tubes. Basically we thought if an experienced nurse couldn't get it, those of us with 0-1 NG tube attempts ever wouldn't be able to get it either.
We mentioned this to our staff at M&M and got ripped apart. How could we be surgeons and not place NG tubes? How did we get through intern year without doing this? "When I was a resident...."
Bottom line, it's not something we do. I wouldn't expect a general surgeon or any other surgical specialty to be able to place a difficult Foley if a couple of experienced nurses have tried and failed. I wouldn't even expect a resident to try, as I assume they're not placing many Foleys, even in the OR.
Just curious of other thoughts on these sorts of situations.
The patient clearly had an ileus and was vomiting and needed an NG tube. We asked the nurse to try, then the charge nurse when that wasn't successful. At this point we considered consulting general surgery for the NG tube placement, as none of us (urology residents) had any significant experience placing NG tubes. Basically we thought if an experienced nurse couldn't get it, those of us with 0-1 NG tube attempts ever wouldn't be able to get it either.
We mentioned this to our staff at M&M and got ripped apart. How could we be surgeons and not place NG tubes? How did we get through intern year without doing this? "When I was a resident...."
Bottom line, it's not something we do. I wouldn't expect a general surgeon or any other surgical specialty to be able to place a difficult Foley if a couple of experienced nurses have tried and failed. I wouldn't even expect a resident to try, as I assume they're not placing many Foleys, even in the OR.
Just curious of other thoughts on these sorts of situations.