NGT: Introduction

Nasogastric tube (NGT) insertion is commonly performed in the Emergency Department. However, it is not a completely benign procedure. Mechanical risks include accidental placement in the trachea or lung, perforation of the esophagus, or even transmittal of the tube into the brain. More commonly, patients experience profound discomfort with NGT insertion. In a recent study, NGT placement was rated by both patients and practitioners as the most painful procedure encountered in the ED, including urethral catheterization and fracture reduction. 1

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Our goal is to orient you to the indications, contraindications and complications of NGT placement; and to teach you methods for proper insertion of the NGT with a minimal amount of patient discomfort.

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Authors	Deborah Wong, MD Instructor in Medicine, Harvard Medical School Staff Physician, Department of Emergency Medicine Mount Auburn Hospital, Cambridge, Massachusetts Todd W. Thomsen, MD Instructor in Medicine, Harvard Medical School Staff Physician, Department of Emergency Medicine Mount Auburn Hospital, Cambridge, Massachusetts
Senior Editor	Gary Setnik, MD Assistant Professor of Medicine, Harvard Medical School Chair, Department of Emergency Medicine Mount Auburn Hospital, Cambridge, Massachusetts
Contributors	Lawrence Mambrino, MD Department of Otolaryngology Mount Auburn Hospital
Multimedia Development	Todd W. Thomsen, MD Instructor in Medicine, Harvard Medical School Staff Physician, Department of Emergency Medicine Mount Auburn Hospital, Cambridge, Massachusetts
	Rob Shaffer, MD Instructor in Medicine, Harvard Medical School Staff Physician, Department of Emergency Medicine Mount Auburn Hospital, Cambridge, Massachusetts