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The effectiveness of ultrasonography in verifying the placement of a nasogastric tube in patients with low consciousness at an emergency center

BACKGROUND: This study was designed to compare the effectiveness of using auscultation, pH measurements of gastric aspirates, and ultrasonography as physical examination methods to verify nasogastric tube(NGT) placement in emergency room patients with low consciousness who require NGT insertion. MET...

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Autores principales: Kim, Hyung Min, So, Byung Hak, Jeong, Won Jung, Choi, Se Min, Park, Kyu Nam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3477076/
https://www.ncbi.nlm.nih.gov/pubmed/22691418
http://dx.doi.org/10.1186/1757-7241-20-38
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author Kim, Hyung Min
So, Byung Hak
Jeong, Won Jung
Choi, Se Min
Park, Kyu Nam
author_facet Kim, Hyung Min
So, Byung Hak
Jeong, Won Jung
Choi, Se Min
Park, Kyu Nam
author_sort Kim, Hyung Min
collection PubMed
description BACKGROUND: This study was designed to compare the effectiveness of using auscultation, pH measurements of gastric aspirates, and ultrasonography as physical examination methods to verify nasogastric tube(NGT) placement in emergency room patients with low consciousness who require NGT insertion. METHODS: The study included 47 patients who were all over 18 years of age. In all patients, tube placement was verified by chest X-rays. Auscultation, pH analysis of gastric aspirates, and ultrasonography were conducted on each patient in random order. The mean patient age was 57.62 ± 17.24 years, and 28 males (59.6%) and 19 females (40.4%) were included. The NGT was inserted by an emergency room resident. For pH testing, gastric aspirates were dropped onto litmus paper, and the resulting color of the paper was compared with a reference table. Ultrasonography was performed by an emergency medicine specialist, and the chest X-ray examination was interpreted by a different emergency medicine specialist who did not conduct the ultrasonography test. The results of the auscultation, gastric aspirate pH, and ultrasonography examinations were compared with the results of the chest x-ray examination. RESULTS: The sensitivity and specificity were 100% and 33.3%, respectively, for auscultation and 86.4% and 66.7%, respectively, for ultrasonography. Kappa values were the highest for auscultation at 0.484 compared to chest x-rays, followed by 0.299 for ultrasonography and 0.444 for pH analysis of the gastric aspirate. The ultrasonography has a positive predictive value of 97.4% and a negative predictive value of 25%. CONCLUSIONS: Ultrasonography is useful for confirming the results of auscultation after NGT insertion among patients with low consciousness at an emergency center. When ultrasound findings suggest that the NGT placement is not gastric, additional chest X-ray should be performed.
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spelling pubmed-34770762012-10-20 The effectiveness of ultrasonography in verifying the placement of a nasogastric tube in patients with low consciousness at an emergency center Kim, Hyung Min So, Byung Hak Jeong, Won Jung Choi, Se Min Park, Kyu Nam Scand J Trauma Resusc Emerg Med Original Research BACKGROUND: This study was designed to compare the effectiveness of using auscultation, pH measurements of gastric aspirates, and ultrasonography as physical examination methods to verify nasogastric tube(NGT) placement in emergency room patients with low consciousness who require NGT insertion. METHODS: The study included 47 patients who were all over 18 years of age. In all patients, tube placement was verified by chest X-rays. Auscultation, pH analysis of gastric aspirates, and ultrasonography were conducted on each patient in random order. The mean patient age was 57.62 ± 17.24 years, and 28 males (59.6%) and 19 females (40.4%) were included. The NGT was inserted by an emergency room resident. For pH testing, gastric aspirates were dropped onto litmus paper, and the resulting color of the paper was compared with a reference table. Ultrasonography was performed by an emergency medicine specialist, and the chest X-ray examination was interpreted by a different emergency medicine specialist who did not conduct the ultrasonography test. The results of the auscultation, gastric aspirate pH, and ultrasonography examinations were compared with the results of the chest x-ray examination. RESULTS: The sensitivity and specificity were 100% and 33.3%, respectively, for auscultation and 86.4% and 66.7%, respectively, for ultrasonography. Kappa values were the highest for auscultation at 0.484 compared to chest x-rays, followed by 0.299 for ultrasonography and 0.444 for pH analysis of the gastric aspirate. The ultrasonography has a positive predictive value of 97.4% and a negative predictive value of 25%. CONCLUSIONS: Ultrasonography is useful for confirming the results of auscultation after NGT insertion among patients with low consciousness at an emergency center. When ultrasound findings suggest that the NGT placement is not gastric, additional chest X-ray should be performed. BioMed Central 2012-06-12 /pmc/articles/PMC3477076/ /pubmed/22691418 http://dx.doi.org/10.1186/1757-7241-20-38 Text en Copyright ©2012 Kim et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Kim, Hyung Min
So, Byung Hak
Jeong, Won Jung
Choi, Se Min
Park, Kyu Nam
The effectiveness of ultrasonography in verifying the placement of a nasogastric tube in patients with low consciousness at an emergency center
title The effectiveness of ultrasonography in verifying the placement of a nasogastric tube in patients with low consciousness at an emergency center
title_full The effectiveness of ultrasonography in verifying the placement of a nasogastric tube in patients with low consciousness at an emergency center
title_fullStr The effectiveness of ultrasonography in verifying the placement of a nasogastric tube in patients with low consciousness at an emergency center
title_full_unstemmed The effectiveness of ultrasonography in verifying the placement of a nasogastric tube in patients with low consciousness at an emergency center
title_short The effectiveness of ultrasonography in verifying the placement of a nasogastric tube in patients with low consciousness at an emergency center
title_sort effectiveness of ultrasonography in verifying the placement of a nasogastric tube in patients with low consciousness at an emergency center
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3477076/
https://www.ncbi.nlm.nih.gov/pubmed/22691418
http://dx.doi.org/10.1186/1757-7241-20-38
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