"Painless" Nasogastric Tube Placement
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- เผยแพร่เมื่อ 3 ม.ค. 2022
- Nasogastric tube placement is recognized as one of the most uncomfortable procedures we do to patients. In this video we demonstrate how to place a (relatively) painless nasogastric tube with some technique adjustments for ideal topical anesthetic administration.
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lidocaine? didnt know that was used. i've had many ng tubes placed with just some lube and a prayer. i guess this way is better
They’re trying to be a little more humane now.
It generally depends on 1) the training and/or empathy of person placing the tube, and 2) the circumstances and situation of the specific patient. I’ve been an ICU nurse for a little over 6 years and I’ll try to get an order for lidocaine for my patients if they’re conscious and can safely wait for the lidocaine to work [obviously it doesn’t help much to give lidocaine and not wait for the numbing to really take effect (~5 minutes)].
On a few occasions, I’ve had to “fight” with a less-than-empathetic MD/NP/PA to get them to order lidocaine for a tube placement but they almost always do it without question. I can remember one time when I couldn’t convince a resident to be nice and order it for a patient who really needed an NG tube but not urgently. I just went back to my patient’s room and had them tell me they would refuse the tube unless they got lidocaine first so I could then tell the MD 😂
Well I'll tell you I had an ng tube placed once and swore I would never do it again. No lidocaine. Just lube and it felt like they broke my nose. It hurt so ungodly bad. Awful experience
@@kellyconley1750 same. ive had a few that went in with lube just fine, and I had one that went down that hurt so bad I cried for about 4 hours uncontrollably lol.
Same with me! I’ve had these several times but never with lidocaine.🙁
Watching the look of horror pass her face when it wasn't as "painless" as she thought it was going to be sent shivers down my spine. I feel so bad for everyone who has had one of these without lidocaine
That is one dedicated resident. Great job. Always better to learn on a live patient that can help you learn what to and not to do. Great job Doctors 👍👍
I remember getting in of these as a kid. Absolute torture, nurses holding me down no numbing at all. Traumatized me. Getting a covid test done triggers that fear.
You know... I think doctors should go through procedures like this just to be able to see where the procedure could be polished up (like when you talked about the numbing and the resistance,) but also so they have more compassion and understanding as to what their patients go through. Some doctors plow ahead and overlook the little ways that will help make a world of difference comfort wise for their patients....
Yes!
Absolutely! sometimes they want to fill quotas and onto the next procedure
Damn doctors are insensitive and just plain cruel 😔 😢 😕 😞.
Had this done in ICU in 2015 and it was the most painful experience ever, it got continually stuck in my throat, sick was coming out my nose, the inside of my nose was so damaged it took months to recover
You are not alone in having this experience
I had similar experience when they tried to fit one in me it was a horrible and after 5 or 6 attempts I refused to keep going it just kept coming out into my mouth no matter what they did and one side of my nose just couldn't fitter tiny tube it was so bad that I refused point blank to have one the nexttime It was suggested as it was such a traumatic memory
Well that sure was some special treatment… I just got held down until I was old enough to just freeze and silently cry until it was over.
I've had several NG tube placements following a perforated bowel (diverticulitis) in 1986, colostomy & then reversal 9 months later. As I got in my late 50's I had adhesions causing obstructions. I'm 69 now and have had 4 obstructions and know when I need an NG and bowel decompression. I actually present to the ER and tell the triage nurse what I need. "Well OK, come on back!" I suppose I could teach someone how to swallow down an NG tube. I've never had the lidocaine and the process hasn't been painful for me. One tip is to make a hole in the top of a disposable bag for your head to pass through so if you throw up, it goes into the bag. So far I've avoided surgery, it generally takes 3 days inpatient for the partial obstruction to decompress. The colic pain is terrible during the onset of obstruction. Thanks for the teaching film, doctor, and thank you for the ER resident participation.
Thank you for your comments!!
As a retired RN & patient that has had to have numerous n.g.tubes, I chuckled with the med student as a willing patient & said out loud “Good Luck!”!!! Back when I had to place n.g. tubes, no lidocaine & just the jelly. Plus, patient just had to swallow!!! Everything was text book. 👍🏼Now I need to decompress from my negative feelings of having the n.g. tubes!
its not that bad, its like a pasta noodle going down the wrong hole
I think its great to use lidocaine but none of the hospitals ive been in provide it, patients just have to deal with the discomfort.
I placed dozens of NG tubes over the years, wish I knew this before. Great work all around.
Thank you! Glad this was helpful!
My daughter has numerous NG tubes while undergoing chemotherapy and even being a child, never once was she offered any lidocaine. They just lubed it and had her swallow a drink very fast. They usually give her a bit of Ativan first.
How is she now? I hope she's getting better!
I had this done last month and they did put the lidocaine in my nose. I wanna say it did make a difference. But I wouldn't do I again. I was gagging none stop putting it in and while it was in.
Thank you for sharing and continuously making these videos Dr. Mellick and team!! You’re helping us nursing students A LOT! 💯💖🙏🏼 YALL ARE AWESOME HUMAN BEINGS THANK YOUUU! 👏🏼
You are welcome! Thanks for the kind words!
@@lmellickPlease reply to me. Could l refuse an NG tube? Could medical staff force me to have it? Goodness......l would rather die!!!!!
I'll tell you that is a lot better then when they tried to get that tube in my nose omg. Felt like that lady was trying to pierce my brain I was in tears.
I had one done just under 3 years ago with no lidocaine. Just a glass if water and will power.
This makes me so mad because when I had an NG tube placed in the ER for a partial bowel obstruction the nurse didn't give me ANYTHING. It is a form of torture. I told my family if I ever have to have an NG tube again, just let me die. I wouldn't wish it on my worst enemy.
OMG i literally had the same experience, it´s the worst feeling in the world, and i too, would rather die than have this done again, it´s literally torture
If the doctor doesn’t place an order for medications we can’t administer anything. On the other hand the patient can request medication and we are more than happy to ask.
I had a bowel obstruction in 2015 and had to have an NG tube in for days. They never gave me anything either. I was always so fearful of having this done. It wasn’t pleasant but my mom was there with me and she was a nurse so I felt better. They told me to swallow but never gave me a drink.
I've had dozens of NG and NJ tubes placed (NJ goes into the intestines not the stomach). snorting lidocaine jelly is the only way I'll do the procedure. I've cried and vomited and smacked nurses while getting NG tubes put in without snorting lidocaine jelly. If the nurses are trying to do it without you swallowing either dry or with liquid while it's going down the throat, they're doing it wrong. It makes it MUCH easier. I recommend having numbing throat drops for after placement (god forbid anyone reading this has to have a nasal tube). In the US the brand name is Cepacol I believe. Advocate for yourself! if you just go along with no lube or no numbing, it will be hellish. My first NG was without lube, lidocaine, or even water to swallow the tube down with. It was a horrific experience. I recommend once they have you prepped to simply go into a "zen state" or semi-dissociate. Makes it go easier for me.
Thanks! Excellent comments!
@@lmellick thank you for your work producing these videos! They are quite interesting as a patient wanting to go into nursing.
@@livyann2143 You are welcome.
I would routinely use lidocaine jelly, the type that comes in a small toothpaste sized tube. Have the patient snort and swallow. Wait a minute and in like Flynn. Worked really well.
@@pnwester2697 this is exactly what they use for me now! I can't believe we are NOT doing these very simple things for patient comfort across the board. Unless there's an allergy to the lidocaine or the lube, both should be used. I just had someone online who asked me for tips for NJ tubes, had one put in WITHOUT LUBRICATING JELLY! didn't even dip the end in water for her! It seems nurses are taught that it's only midly uncomfortable. It can be incredibly painful. I don't blame them, they clearly don't know what it actually feels like and they are taught that it's fine.
Just because patients CAN get through the placement without lube or numbing, doesn't mean they SHOULD HAVE TO. This isn't about silly patient satisfaction crap, this is about possibly traumatizing a patient. I still get flashbacks to that first NG placement as a young teen (where the nurses berated me for complaining it hurt and they used no lube, water or numbing) while getting them placed within the last few years. I went very malnourished for 3 years because I refused to have another tube placed due to the trauma. by the time I agreed to an NJ tube, I was 85lbs and so malnourished that I would faint if I raised my arms above my head. I still have damage from the malnourishment. It does not add any risk (except allergy) to use lidocaine and lube and these two item are cheap too. A packet of sterile lube is about 10¢ each when buying it for myself for catheterization. The bulk that hospitals can buy it for, must be even cheaper. Lidocaine isn't some rare drug either.
edit: with lidocaine the procedure is SO easy for me that I'd GLADLY volunteer for nurses to train on me with NG tubes.
Painless my butt? I had this procedure performed on me for intestinal blockage. First off, I didn't see lidocaine anywhere, secondly my nose bled like an oil jack striking oil and still they persisted, as I tried to grab the doctor who was doing the procedure, he managed to hit the bricks flying but the nurses somehow got it in during my distraction. I remember a cough and making a move to yank it out and they said 'don't, it's in now.' Didn't hurt but it was extremely uncomfortable. I really hope never to have to go through this again.
my favorite thing about residents, the literal human guinea pig. nice job girl
Thank you.. i will try to reduce the discomfort of our future patients.
I have Dysphasia, at this stage not sure exactly what it's causing it, but I have a very large full Goiter (supposed to have surgery to remove the whole thyroid but COVID has stopped most elective surgeries in my country) Sjogrens Syndrome, Eosinophilic Esophagitis, a form of Dysautonomia and a recent Anterior (they actually cut a quarter of the way around my neck, not the 3-4 centimeter incision they told me I would have) Neurosurgery. The surgery was a partial corpectomy, discectomy and general clean up, unsticking the Peripheral Longitudinal Ligament, stacked cage, spacer and fusion in the C3, C4 region. As I am on immune suppression I have been afraid to go to risk going to any medical appts so have not even had a swallowing study yet. I have seen a Speech Therapist who said she could arrange a NG tube while I wait for surgery. I have lost about 30 kilo's. My major problem is not being able to take all the medications I need to take. I have killer gag reflex which is the main reason I am hesitant to have an NG tube put in. This video has made me want to try getting the NG placed. I am not afraid of the discomfort so much it's them not being to get the tube in because of my gag reflex. Do you think numbing the area would help stifle the gag reflex? Thanks in advance.
I’ve been a registered nurse for over twenty years and I’ve only used ever KY. But the last NG tube I inserted was about 18 years ago. Would’ve been nice to have all these extra goodies to use (especially all that lidocaine!)
I’ve been a RN for 30 years in ER and PACU as well as other modalities. Never have I even seen lidocaine used. Have had NG tubes myself and would have loved some “numbing”.
So back in 2005, I was involved in a chlorine release involving a train wreck. I was admitted to Doctors Hospital. It wasn't an NG tube but they put a tube going down to my lungs. Still to this day I do not know what they found.
Wondering about the numbing for the NG tube- I thought they were pretty well tolerated in the upper aspect- Its generally the bolus into the stomach that is a problem?
Brave resident!!! Thank you so much for the video
Agreed. Thank you!
I needed this! Getting NG tubes are rough! Hurts like hell!
Didn’t know they used that now? When I had it they use water or lube which hurt for me since my stomach didn’t want the tube.
Glad to see this demo as a nursing student. Thank you.
Glad it was helpful!
Lidocaine would it sting if deep in there and cause more irritation later? I had an in office nose scope and that hurt. But I would agree deeper and spray harder would prob be better. She was gentle when it prob didn’t need it. With inserting the tube I also feel faster is better. In terms of verifying it usually you would see it coiling by that point so could have started swallowing more quickly
I’ve had 2 sbo’s & had to have one. They gave me some versed the 1st time. Was in for 4 days. It was hell! It hurt in my face like I was being punched by a linebacker. I’m a retired RN & have placed many ngt’s & managed/removed too. Never had a patient c/o about pain like I was having. It’s normal to have it be irritating but what I was feeling was so beyond that. The tube had to be pushed in a bit & I thought no problem. It hurt so bad I broke down sobbing. It shouldn’t have hurt that bad! I was eventually referred to ENT after dc & I had a CT. Nothing except a deviated septum. My next ngt insertion was ok but should have had a larger one. It was a 10 I think. Ended up having surgery & they replaced it with a 16. No matter how technically smooth it goes in I am still beyond scared. I am subconsciously evaluating even the slightest twinge for possible obstruction.
Medical people have a bad habit of telling patients it’s not a painful procedure … or downplaying the patients pain, so no , you were not the only one to suffer this horrendous pain , you just choose to disregard the patient and put it down to them being an over reactor/ dramatist, an hysteric,
I’m not watching this cos it will trigger my ptsd from my long stay in paeds and then a psych ward for anorexia (even though I actually had and have severe ocd and my compulsion was to starve myself for 14 years). My 1st NG tube hurt so much. My second hurt less. By the 3rd my favourite nurse decided to take over changes and she could do it so quick and gently it was barely worse than a blood test. It’s all about the skill. Lube and lidocaine help but it’s mostly the nurse doing the procedure in my experience. Thanks Sandra!!
The hinted Nebulized lidocaine sounds like a smart approach if as effective . Would probably need more time and material but love the idea.
Hi Dr. Mellick!
Several years ago, I had to have an NG tube placed in the ER prior to emergency surgery for a bowel obstruction. Both issues were a first for me. It was a quite a learning experience for all involved - the medical personnel as well as myself. (The procedure for me in 2008 would be just as described above, except for the part where the nurse looked up the nostrils. And never having had anything but allergies, no one had ever said to me whether or not I have a deviated septum.) Well, anyway, things seem to be going along alright when the doctor suddenly stops and says to the nurse, “She has a deviated septum. We have to back out and try the other side.” Ugh. Up until that day, I had no idea I have a deviated septum. So that is what the doctor did. Soon after, I was getting used to having an NG tube in my nose. (I did know that my father had one growing up, and it was corrected through surgery as it caused him a lot of problems throughout childhood. I was in my twenties when this happened, so I was told that my deviated septum can't be all that bad if it was only now in October 2008 that I was learning about this.) After that hospital stay, I was back in again for another problem (pseudocyst), but still the ER doctor wanted to another NG tube, until the problem had been diagnosed. Remembering what I just went through, I didn't want to go through that again, so now I just say to anyone who asks "go up the left side, please." LOL
Dr. Mellick, I want to thank you for reading this and for your wonderful videos as well. I hope what I have said is helpful.
Thank you! You are very welcome!
Had one of those recently I was gagging I never want one of those tubes ever again 😮 but it did do it’s job had a SBO it was painful
Thank you, this was very informative!
I've never seen an ng tube placed with numbing. I've only ever done a little lube and maybe some water if we're lucky. I feel like I remember something in nursing school suggesting that numbing the throat would make the patient unable to protect their airway but obviously, that was wrong!
is painless procedure for unconsious pateint too ??
i have did nso procedure amot 5o to 60 patients
I've had NJ tubes that turned into ng and they hurt I had them take it out right after. They said well we can only take out ng not NJ and I told them if I'm puking up the formula it's in my stomach.. I got like the tip of the catheter with the lidocaine jelly and the rest was lube, this looks way less painful
Dr. Mellick, any advice for longer term NG tube pain management? After a GSW to the abdomen with multiple bowel resections, despite adequate systemic pain management, throat pain from the NG tube was unbearable. The only relief I felt was when the tube was flushed to clear it. The nurses were amused that I would request them to flush more often. Thankfully I was in CCU so they had time to be able to do so.
Thanks for your comments!
You have a great job!
I have had this done several times. I was cooperative and it hurt like hell!
It’s really not horribly painful it’s just very uncomfortable but once you get use to it the easier it gets.
I have used a lidocaine containing lubricant before to intubate patients, but I've never used pure lidocaine. This sounds like a good approach for an oriented person, but I'm not sure I'd use it on a disoriented patient
Not sure what would be worse, all the fuss with lidocaine or just a well lubricated NG tube, good patient positioning, and a full cup of water. If you set yourself up for success it is quick and easy. Just whatever you do, don’t place it in the spinal column.
We don’t use lidocaine ever in the UK. It would be only in extreme instances. I’m the queen of NJ placements in critical care as I always get it in quickly and with minimal pain or difficulties. I’m also a crohns patient and I have spent too much time in hospital and have had many NJ placements. I generally will place my on NJ tubes as the staff know me and I can again do it quickly and seamlessly myself so unless I’m currently vomiting and wrenching it’s easier to just let me do it lol !
NG or NJ? This video was of an NG tube placement, not an NJ tube placement. I’ve had both multiple times. Every hospital I’ve ever gone to (US) only does NG tubes (tube empties into the stomach) while the patient is conscious (like this video), and only does NJ tubes (tube empties into the small intestine/jejunum) while the patient is sedated in order to go in endoscopically to ensure proper placement in the small intestine. Just curious if you meant NG instead of NJ, or whether things are done differently in the UK altogether.
Also, what was done in this video with the lidocaine is definitely not the norm in the US. I’ve had countless nasal tubes, both NG and NJ (though now have a surgically placed permanent feeding tube), and not once has anyone ever mentioned lidocaine as an option. It’s always done without lidocaine. I also know many other people who have never once had lidocaine used for the procedure. It’s always done lidocaine free practically everywhere in the US, with the technique demonstrated in this video being the exception not the majority. Honestly, I think for most patients, using lidocaine is going a little too far, as while it’s not a comfortable procedure, it’s also not the worst, and is over and done with so quickly. Maybe for younger children it would help, but for the average adult it just seems a bit much, and it didn’t seem to make that big of a difference compared to how it would be normally without lidocaine. For me, the worst part isn’t the insertion, it’s what comes after. My esophagus is so sensitive (likely from a lifetime of being messed with, and damage being done for the first nine years of my life prior to surgery with extreme severe reflux that was causing permanent damage), so the tube is extremely irritating to the tissue to the point that it formed lesions and bled for the entire duration that the tube would be in, though I know that’s not the normal experience. Either way, if I ever had to get a nasal tube again and lidocaine was offered, I’d probably just chose to go without it. I guess for patients that want it though, it would be nice for them to have the option, I’ve just yet to see that being commonplace.
Brave resident and great job RN!
Agreed!
My mom had a bowel obstruction and she had to have a NG Tube for 2 weeks waiting in a surgery to repair it.
Very helpful video thanks Larry ❤
You are welcome. Glad it was helpful.
@@lmellickPlease reply to me. Could l refuse an NG tube if lam mentally competent? Could l make a Living Will, refusing intubation, ventilator, feeding tubes? If l were to suffer severe burns, get run over, have a car accident l want to refuse ALL lifesaving measures. Just palliative care. However, doctors in their arrogance force people into life, when they don't want it.
@@lmellickEnjoyed it, great video!!!
Hi Dr. Mellick, I plan on working as an ER tech after I get an EMT license. Do techs in your hospital work with the ER docs? I’m doing this for clinical experience for med school, but I wanted to know if this would be a chance for me to see what an ER doc does since I want to go into EM. Thanks
For sure. Your plan is good!
Wouldn't lidocaine affect the person's gag reflex? The tube can still get inside the patient's trachea without causing any distress. We usually just use a lidocaine jelly inside the patient's nasal cavity and ask him/her to sip some fluids while the tube is passing down the pharynx.
True I’d rather be in pain than have a life threatening issue (I had numerous NGs placed)
Very informative. Much respect for the resident. Maybe a pass with a similary sized endoscope would reveal where things were hurting? This may improve numbing?
We did the next day, and it didn't show any major narrowing.
@@lmellick Very interesting. Thank you for sharing that detail.
That was very helpful.
Great to hear!
Had it done, and told my Doc never again knock me out bore a hole in my side and feed me with a shovel! This day and age this procedure is voodoo!
YES!!! 😂 The Worse thing ever. It done it's Job YES however 🤮🤮
Get SOME, Dr. Hall!
I wouldn't volunteer to do that especially in front of a camera
Much respect for the Resident
I volunteered myself as a patient to let a medical student do it so she could learn what TO do and what NOT to do. For that being her first time ever even seeing an NG tube she did amazing.
I had a a bowel obstuction a little over two years ago, and had to have this procedure, I never got any numbing liquid it was just drink the water, let me tell you, I have PTSD after this, now let me tell you I have terminal ovarian cancer and have been through chemo and treatment for the past 4 years, this procedure was by far the worst thing I have every gone through in my life I'd rather have a cut to my stomach and the tube inserted that way than this it is horrific and very unplesant .
my last ng tube was way bigger in diamiter was 1cm wide as was a small hospital and thats all they had had to have that in for 2 weeks before could get replaced with a proper nj tube as mine fell out. Its not that bad with the proper size tube.
This large tube should have been put through the mouth is much better is the one used for stomach lavage
Uhhhhhh, this stuff tastes awful until the numbness hits......I had something like this to check my swallowing function. Bleh.....kudos to your volunteer though.
Larry, can you post a video on treating Bony Mallet Finger?
Thank you!
I may have an old one posted years ago. Do a search.
I have recently been seen in ER for a small bowel obstuction and had to decompress with NG, but funny thing is the ER instead of using lidocaine put the NG tube in the freezer to help cool the tube to slide it in better. As an EMT I never heard such of thing.
I would stir it around in some ice water. When you’ve tried to put it in more than once or twice, the tube starts to soften and you need to harden it up again
That girl was a champ
Agreed!
Hi my name is Erka. I have had had gastric issues for a good portion in my life. It was April of 97. I was taking doses all day I don remember what time but I went at least 11 times. I looked down and see them and I didn’t think anything of it. I didn’t feel or hear anything pop no pain I noticed that they were jet black , with a tarry consistency and stinky. About 8 pm that night I payed down that time on the couch and said mom I’m not feeling well I didn’t know why but I knew that what ever it was that was happening was bad and serious and I needed to get to the hospital fast. I had all kinds of tests done nothing overly painfull there was no blood or toxic content sitting freely in my stomach but it was bad. I had some kind of test done to check if I was bleeding out. When the dr told me I had lost a lost a lot of blood, I was diagnosed with a duodenum ulcer and I’m guessing it popped and looked like a crator. I had a upper endoscopy done the following day. I got a blood transfusion. Things weren’t looking good for several weeks. I was so sick I was throwing up a lot. It would even wake me up because I was so nauseous. They changed my sheets and smock and I was given a really strong med to stop being nausea and vomiting. I developed icu phsycosis and I had to learn how to live again. The following April possibly the same date I was woken up by sever abdominal pain. So I screamed and my parents came and rushed me there again that time I had blood that was just sitting in my stomach. So I’m taken to this room where a dr and some nurses were going to put in a nag tube. They had to use a pediatric one and when they did that procedure they didn’t warn me that it was going to hurt. No sedatives no analgesics and th3y just tamed that bartered down my nose to my stomach I screamed bloody murder. I thought I was going to die. I couldn’t swallow properly and it hurt like hell. I will never let a nother dr do that ever again with out anesthesia.
I like tat the “painless” is in quotations. The nurse acted like she was so confident in what she was doing yet didn’t do anything quite right. I hope that it was a good learning opportunity for her! Also, kudos to the girl that was brave enough to have this done. What a great way to learn how to do something!
А почему перевода нет.
What the hell do you guys do in the states and what gauge NG tube. I just had one of those no lignocaine needed just a trained nurse and correct timing with swallowing it was over quicker than you guys squeezed the anaesthetic out of the tube. Is it done like this for the insurance or what. It was uncomfortable for about 10 seconds but not painful.
not everyone has the same experience as you
What is the patient doesn't want to swallow
I am currently in my role transition and we were told we are not to verify placement anymore by auscultation, that it can only be verified by x-ray now? Do you have any insight to this? I have been an LPN for ten years and I remember learning to verify by auscultation but now in my RN they are stating this is no longer in practice?
No insight into that. If any viewers have any information, please let us know. I wonder if that is only a local recommendation.
You use auscultation for temporary verification (make sure you don’t need to go down deeper) until a chest or abdominal X-ray is ordered and taken. X-ray is the gold standard per current literature
It is my #1 fear in life to need to get one of these. They terrify me.
Just got it off after 3 days with it. Was not fun in the slightest and I thank god for the patience I was given. I was really about to go mental lol.
@@armoredgaming2352 I can't even imagine! You are strong AF! I'm glad you're off of it though!
Me too!! I’m literally watching videos preparing myself in case I ever have to have one 😂 worst fear
I developed an ileus after Dr. Ryder removed my colon in September. The first 3 days after were by far more painful than the actual placement.
I had 4 or 5 nurses/nursing students in the room wanting to watch. They mentioned another patient having one placed an hour or so before me but he had a hard time getting it and keeping it down-- so much so that he had to have it placed 5+ more times by that evening. I wonder if this technique would have benefited him?
My Mom had this procedure done today & she couldn't tolerate it. The guy who was doing it wasn't very good in my opinion or hers. To be fair, my Mom did try a second time but it was equally bad as the first attempt. I will state the following facts. The numbing spray they put in her throat & nose (no jelly for the nose) she said tasted like poison. After watching this, I believe that the guy sprayed too much into her throat both times but of course I can't really be sure. All I know is that both times she threw up violently & for a couple of minutes. My Mom has a sensitive stomach & since she was on an empty stomach that just made matters worse. The guy was going extremely slow in putting in the tube, my Mom kept saying "OMG you're so slow! Can't you do it any faster?" The first time, it was almost in place but when she started gagging & then throwing up she just yanked it out on her own. She continued to throw up what little water she drank & then started crying. She said "I can't do this! The combination of the numbing spray & his inability to put in the tube in quick manner caused my Mom so much stress, anxiety & fear!" He actually said to my Mom "don't you want to find out what is wrong with you? You have to do this, so let's try again. My Mom said please give me a few minutes to think about it & let me calm down from this horrible event! My Mom then agreed & said, I will try 1 more time so nobody can say I didn't try. He asked her if her throat was still numb & she said yes, then he said let me put some more, to which she said no I don't want anymore because it's making me sick to my stomach. He insisted & she agreed. A second spraying was done & she started to gag & throw up again. I tried my best to support my Mom & told her you can do this Mom, I'm right here, hold my hand ok? He did exactly the same procedure as the first time & once again she started to violently gag & vomit everywhere. Oh yeah, my Mom was wearing her street clothes & they didn't even give her a gown to change in so she just vomited all over herself, sad. I felt so bad for my Mom. This guy (technician or whatever they are called) was not sympathetic or empathetic to my Mom, he just stood there like a robot while she was hurling her guts out everywhere! Didn't offer her kleenex or a barf bag! He was a dirt bag in my opinion. We were at Toronto General Hospital in Toronto Ontario Canada.
My Mom was diagnosed with stage 4 Cirrhosis of the Liver a year ago so this was our second time at this hospital. So, after the second attempt the guy said why don't you go & wait in the waiting area & I will take my next patient & we can try again after I'm done. My Mom said a big fat NO! No thank you sir! I asked the guy "do other people have as much trouble as my Mom did today?' He said yes, it does happen from time to time as everyone is different. I remember at one point the guy saying something to my Mom & all I remember her saying was "I know myself better than you know me & I know what my limits are! You know nothing about me so don't talk to me like you've known me all my life & know what I can or can't do!' This guy just had no heart. I felt like this was just a "JOB" for him & he was clearly missing the aspect of what a medical professional should have towards "helping people" He told my Mom to pretend that she was drinking a beer or a cocktail & try to use "mind of matter" to overcome the wretched taste of this numbing spray. She replied, "I don't even drink alcohol OMG!" So we are home now & my Mom will be calling her Gastroenterologist to see where she goes from here. Her liver biopsy is scheduled for next Monday & when she asked to have sedation for the procedure they denied her & said "normally everyone is awake during this procedure" OMG, I don't think my Mom will be able to go through with the biopsy without sedation but she's a trooper in my eyes & like today, she said "all I can do is try right?" If I can do it then great, if not, then I can't. People have limitation to what they can cope with & this guy did nothing to ease my Mom's anxiety or try to help her relax no, his response was, "if you don't do this procedure today you will not be able to find out what is wrong with you, so don't you want to know why you're sick?" To say the least, my Mom is upset & not happy with the result today. I'm very unsatisfied with how the procedure was done. Oh by the way, my Mom was not told that she was having 2 procedures done today. She thought she was just having an ng tube put in & kept there for 24 hours. She was not made aware that she would be having a camera inserted for 10 minutes to take pictures of her swallowing. System failure. Canada's Healthcare System has been nothing but a failure ever since Covid & the Hospital's here in Toronto Canada fail to provide adequate medical services to my Mom (I would never presume to speak for the entire City of Toronto or Canada, only what she's been through) I asked if there was another option that could be done since today was a complete failure & he said very plainly, NOPE. He was a man of few words. He didn't say goodbye to either of us, he didn't give any words of encouragement to my Mom, like hey good job, you tried twice so I will give you credit for that, no. He offered nothing.
If anyone would like to leave me a comment or ask me any question about today please feel free. If anyone has any advice, I would greatly appreciate it. I read quite a few comments about other people's experiences & it seems to very from person to person. Some great, some bad & some horrific. I can say that watching my 57 yr old Mom go through this today was difficult for me. She's a strong woman who's been through 2 c-sections, a knee operation, a snowmobile accident that caused her chronic back pain now for 32 yrs., it took her 9 months to walk again & steroid injections in her spine...so I know she's tough but today this procedure kicked her in the butt & I'm 99.9% sure that this guy (tech) was the sole reason she couldn't do it. Can you believe that after what she went through today she's going to actually try again? She is going to ask to go to another hospital, have NO NUMBING SPRAY this time & ask that it be a SENIOR TECH perform the procedure & not some 20 something tech with barely any experience with an NG tube!
If you read my comment (story more like LOL) thank you. I just had to get this off my chest. My MOM is resting now. If you would like to pray for my Mom that would be so great, we need prayers for healing & for her biopsy next Monday! Take care & have a Blessed day everyone!
This sounds traumatic. Everyone is different. Some people have extremely sensitive gag reflexes, etc. while others have severe anxiety. Nevertheless, there is an art to this, and it is possible to place these tubes almost painlessly.
@@lmellick Thank you for your response! 0-2 on the anxiety & gag reflex so her chances of success were not in her favor. I appreciate you taking the time to give your feedback!
Did your mom end up trying again with a senior tech??
My mom had a similar experience. She has a small bowel obstruction and when the nurse was putting the tube in the nostril my mom gagged several times and she had tears rolling down her face and her nose was runny. This all the while her stomach’s bloated and she’s extremely nauseated. To make things worse after it was placed come to discover it wasn’t inserted all the way because that was the best the so called nurse could do. After that my mom couldn’t breathe at all and started chocking violently. I patted her back and said nurse please help she can’t breathe. The nurse kept smiling for some odd reason and then eventually responded and said “she’s fine, it’s normal she’s fine.”
My mom kept saying she can’t breathe so I told the nurse “you have to take this out right now she can’t breathe.” Out of nowhere another nurse pulled me aside while my mother is struggling for breath to tell me she’s fine. I went back to her she still can’t breathe. I said “okay that’s enough to take it out.” The nurse finally took it out but appeared very irritated and smacked her lips like she was annoyed. So now I’m determined to wait for another nurse on shift to put it in.
It was a horrible experience and I understand exactly how you felt. My mom has also been through a lot physically and to see her in that much discomfort was overwhelming.
We are in the US and some of these people in health care have a God like mentality over here in many of them and feel they can do no wrong. They don’t like being told anything either that contradicts their treatments even if it’s to the patience best benefit. The tech your mom had to deal with sounds like a jerk. I think what it is is a lot of them also don’t care and see patience’s as just another number and not as individuals or human beings. They have lost some of their humanity as professionals and people due to their egos and the fact the ones they are treating are not themselves or anyone they love, so at the end of the day many them don’t care.
I hope your mom is fine. No one who doesn’t have a sick parent understands the mental, emotional, and physical suffering we as their children go through having to see someone you love more than anything go through so much pain. On just a human level it’s horrible to see anyone go through that, but as a loved one it’s even worse. I pray both of us have healthy moms who are cured of all their ailments. 🙏
Y'all get anaesthesia and a glass of water during it? Is that common practice? The doctor I saw just shoved it down without anything else.
super like doc.
I’ve had three ng tubes and never was I given a sedative or lidocaine.
sedative is not worth it here, analgesia is not usually given beyond the lignocaine jelly since its not required. theres concern of tox with the ligno which is of course overemphasized and rare given the usual dosages. some older clinicians still cling on the belief that the local analgesia may cause higher risk of aspiration so they're against it.
if youve already needed 3 do you have some condition? you should ask for the atomized ligno in the future if they have it
Painless? Lol... not so sure its painless. I've never had a painless one. But certainly not excruciating. Quite uncomfortable after placed also. Miserable to have for any length of time.
Agree! Just got mine taken out like a day or so ago, thank god.
Hold me down or knock me out if you have to do it on me.
This feel so awful getting this I had it done it hurt so bad in your throat 🥺🥺
This looks like one of my worst nightmares
its not that bad, its like a pasta noodle going down the wrong hole
Same, anyone who had to do this is so strong 💪
it is, im still scared of having to do this in the future, it was dont to me 8 years ago, and i told em: "or u take it off or I will "
Shes brave for volunteering!
Id "volunteer" to, for like $50
NG tubes hurt so bad I remember when I was 7 they had to get 4 other nures to hold me down lol
Same!!! I was around 7 when I had one! It was the worst pain of my life! And I’ve gotten fingernails ripped off completely!
This is a much better outcome using the lidocaine. I’ve had many NG tubes inserted for bowel obstruction. They were put in with nothing, no lube and no lidocaine. My worst nightmare. Your way seems a much kinder gentle way to put the tube in.
Agreed!
Yeah I’ve a few obstructions myself. The ng tube is the worst. I would prefer have surgery rather than another ng insertion.
This worked well, but I would suggest maybe adding Oxymetazoline .05% as well. Patients often perceive the tube to be smaller and less uncomfortable if this is used not to mention it reduces the chance of nose bleed. Obviously though this worked fine. The resident is a trooper; I wouldn’t have volunteered for that.
Thanks for your suggestion. We did have that ready and available.
Hlow sir..my name is jayanta and I am 18 years old...sir have a question ....sir if someone have testicular torsion and if he didn't treat it since 1 month ...is it possible that the tortion is automatically detorsion.....or you have to do surgery neither you will be in pain untill you do surgery..pls reply
If you still have the testicular torsion, there is a high probability that the testicle is already dead and needs to be removed. Detorsion does occur, but it goes back to normal appearance and lack of pain. If it is still swollen and abnormal in appearance, the chance of survival at one month is basically zero percent. If the dead testicle doesn't become infected, the remaining testicle will atrophy or become small and basically scar tissue.
Sir, I feel that my testis size become significantly smaller than the others. ...so what should I do now? Pls guide me ...at this time , will surgery be the option to protect another testis for my remaining life or just left it as it is ?...
@@jayanta0128 No.
I am not a medical dr but testicular torsion is EXTREMELY PAINFUL.
I dont know how one can go 1 month with the testical being twisted unless it untwisted itself & resumed blood flow or the pain was (somehow) endured throughout the torsion to the death of the testicle. In torsion, It would have been noticeably swollen, red & very painful. Testicular torsion is an EMERGENT condition and requires immediate ultrasound for diagnosis & surgery for permenant correction to save the testicle
Note that some episodes of torsion are intermittent (can untwist or self correct) but the chances of reoccurrence is quite high.
You need to see a doctor to evaluate both testicles. If you feel that pain again, or if you experience swelling, redness & pain, do not wait to see a doctor. Go immediately! Waiting any time at all is very dangerous.
In the testicle that experienced the torsion, if it is dead, you can not risk failing to treat an infection. If the unaffected testicle experiences torsion & you do not seek help it could quickly die as well leaving you infertile & unable to produce testosterone.
Please take care of your health. I am sorry you experienced this.
@@wendybesse90 thanks....now I have done ultrasound that shows my testicle is significantly smaller than the normal one ....is it ok to take it as it is or take the dead testis away through surgery
Why was she holding her nose at the end? Do NG tubes cause nosebleeds?
She was trying to prevent it from being displaced, so that it doesn't migrate back out, which is what you would do on a real patient prior to securing it. As the inserter was saying if she had a second set of hands, she would have that person hold the tube, while she checked placement and then secured it. They can cause nose bleeds, generally minor, but that is why Dr. Mellick asked if she had a hx of nose bleeds, as you can use Neo-Synephrine nasal spray to constrict the blood vessels in the nose to reduce the risk of causing a nose bleed.
There is usually no problem of bleeding if they do it to me without the spray, directly and if it is smooth, nothing happens
Good answer.
I have almost gotten this done before I am eleven but I almost had a panic attack when they suggested putting one in because I have had traumatic covid tests.
Thanks for the video... I think the results are a tiny bit skewed because you used a smaller than normal NG tube, usually I would put in a 16 or 18.
@Lady Joker uh yea, doesn't change the fact that they used a small pediatric sized NG tube and not the typical adult size. I know they did it out of kindness for the person on the receiving end, but I have a valid point. FYI phyisicians don't usually even put NG tubes in, NURSES DO, and no I am not just playing one in the comments section.
Hate these, I can feel this
I was supposed to get an ng tube placed in my intestines but when they tried, the student stuck it down my esophagus. No lidocain(idk how to spell it lol) hardly any lube. I tried signaling her to stop and that I can't breath but she just said thats normal and kept going. I never got my heart medicine that day either so when I couldn't take it anymore I fell back and snatched the tubing all the way out myself.
It's supposed to go into the esophagus
I think she meant trachea.
@@smolkitti8147 yeah that was my bad.
I prefer no numb. It shouldn't hurt and if it does you need to stop. I prefer to know
How do you do it so it doesn’t hurt? Every time I’ve had a tube placed or done my own it hurts so bad, but I didn’t know numbing was an option
So glad I was knocked out when mine was put in
Cause OOF
Ich hab die Dinger einfach durch die Nase geschoben bekommen. Ohne Betäubung, ohne Wasser... Dass das betäubt werden kann und man dabei Wasser schlucken kann wusste ich gar nicht 😕🤔
La vida real es diferente, ya sonda nasogastrica, la gran mayoría de veces, se utilizara con pacientes que bien o estan irritables o con alteración de la conciencia. Muy distinto a lo que se muestra en el video.
Confirming NG placement by auscultation of an air bolus is not evidence-based, get an x-ray and check residual pH.
Yea, OK, but auscultation of the stomach is immediate as well as other presumptive methods. CXR usually takes some time and it's only true for the the moment the film was taken. Clinical staff working with an NG will continue to make presumptive assessments throughout the use of the tube.
I was coming to say this.
@@pnwester2697 You can still hear an air bolus if the NG is in a lung.
@@jamesconley5255 Tubes and things like centrally placed venous catheters can migrate. An x-ray to confirm placement is great but only confirms position at the time the film was taken. Clinicians need to use assessment tools to confirm position with every use. My best most recent example is using an infusaport for chemo. I was flushing a patient’s line when she felt a cold sensation and a little bit of discomfort by her ear. I was getting blood return but not brisk like I had before. We asked for a dye study to confirm location of the tip. It was in a vessel going up the outside of the neck. Initial placement had a confirmed it was in good position. Had I relied on the imaging study used to confirm initial placement, both the patient and I would have been in big trouble.
@@pnwester2697 Sounds like you made the right call. I hear you, an x-ray is only good at the time of the x-ray. For NG tubes, however, you could always just check for residual (color, quantity, etc) and check its pH. If it's 5 or less, you know the tube is in the stomach. Listening for an air bolus doesn't differentiate if the tube's in the stomach or the lungs.
“(TW discussion of violence ) “So I had to get one and I had to get one because I have been really struggling with an eating disorder and I was not in a good state and so they had to put one in but they did not do it correctly they kind of just came into my room randomly and they were like Mom we have to do this they didn’t give me any water they put lubricant on it that’s it they didn’t do anything else and I started like hey stop it and then they pinned me down and shoved it down my throat and it started bleeding and they didn’t do anything luckily the person who did this was fired
hopefully you are better and coping from this situation, ed units are scary from personal experience, and so glad that person was fired
I remember doing this with my daughter when she was a baby. 1st time I made her nose bleed & my husband almost threw up. No pain meds were given though.
Babies sinus passages are not as developed. I imagine it’s still uncomfortable but not as uncomfortable from what A DR told me when my kids got it in nicu
There would be a risk putting lidocaine into a neonates nose, as they are obligate nose breathers, thus clogging one or both nares with lidocaine jelly could cause respiratory distress. This is obviously not a problem if the neonate is on a ventilator.
All I know is I can't let this young woman show me up, she volunteered I guess if I have to have it done to me, Just do it!!!
Can you feel it in your stomach??
Not really… Most people only “feel” it in the nose and back of your throat. I unfortunately have severe GERD and if the ulcers in my esophagus are bad enough it can cause some pain. The only way I can describe that feeling is kind of like when you accidentally swallow a sharp chip??? Idk either way no you most likely won’t feel it anywhere except nose and throat… so hope that answers your question
@@tyrstyranny7060 Does it trigger your gag reflex at all?
@@kitterzy Once in place no the tube doesn’t make you gag…. when inserting the tube most people will gag though. That’s why they give you the cup of water and essentially tell/yell for you to keep swallowing. It helps the gagging as your brain is focused on drinking while simultaneously aiding in guiding the tube into the esophagus faster. It does feel weird for a while once in… like whenever you swallow you can feel it tug a bit on the tube. Otherwise you get used to it after a while like most things.
No, I didn't feel anything in my stomach, once the tube is inside, you don't feel any discomfort even if you have it for a long time.
I wish it was you guy who put mine in many years ago, would have to be the worst medical experience I've ever had
I had multiple nj tubes placed, which means it goes down further past my stomach and takes longer😅it’s not painless in anyway😂
I had to put one in a blind and deaf lady who didn’t understand what we were doing. Horrible!
Gosh, that sounds awful!
Whats the point of living when youre blind and deaf...
Trust me it sucks