Extraordinary Tube Insertion - Fatal massive hemorrhage caused by nasogastric tube misplacement in a patient with mediastinitis.

The question of whether to insert a feeding tube is one of the most difficult issues in the management of severely ill patients. We...

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  • FATAL MASSIVE HEMORRHAGE CAUSED BY NASOGASTRIC TUBE MISPLACEMENT IN A PATIENT WITH MEDIASTINITIS.
  • AN ALTERNATIVE TO THE NASOGASTRIC FEEDING TUBE IS THE GASTROSTOMY FEEDING TUBE. THIS TUBE IS INSERTED THROUGH THE ABDOMINAL WALL...
  • NASOGASTRIC TUBE INSERTION IS A ROUTINE PROCEDURE IN MEDICAL CARE.
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While we have no explicit guidelines in Scripture, our response is not inconsequential. Many are not conscious of hunger or thirst. A feeding tube may be an easy way out, but this is not acceptable. This report illustrates the complication of massive bleeding that can occur immediately after misplaced insertion of a nasogastric tube.

If abundant fluid is given to the patient by a feeding tube, congestive heart failure may result if the lungs fill with fluid and cause a distressing shortness of breath.

It appears that, for some, starvation and dehydration are rather uncomfortable and provision of food and fluids contribute to comfort. Extraordinary care should be taken to avoid misplacement of the nasogastric tube during insertion.

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As believers, we are not free to do anything we want; rather we are freed from the forces that have kept us from doing what is right. It appears that, for some, starvation and dehydration are rather uncomfortable and provision of food and fluids contribute to comfort. If abundant fluid is given to the patient by a feeding tube, congestive heart failure may result if the lungs fill with fluid and cause a distressing shortness of breath.

It does not include someone who is stable though disabled after a brain injury or stroke. Emergency endoscopy showed that the bleeding came from the nasogastric tube which had perforated the esophagus and possibly tore an intrathoracic large vessel. Is it to prolong life?

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The choice of whether to use a feeding tube is a solemn matter. All too frequently, however, a statement is made in very categorical terms whether or not to use a feeding tube.

The difficult situation lies with the patient who is mentally incompetent, has not left clear instructions, and is dependent on the feeding tube to live. Factors contributing to the risk of esophageal perforation in this case included coexisting mediastinitis, surgical manipulation, endotracheal intubation, inability to cooperate during general anesthesia, and repetitive advancement of the nasogastric tube.

This may be considerably more painful than any discomfort associated with starvation and dehydration. Salinas hookup

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