The hidden dangers of a common clinical procedure
When patients cannot swallow, a nasogastric tube provides vital nutrition and medication. While a routine part of acute and chronic care, the insertion of these tubes carries significant risks, ranging from simple discomfort to life-threatening respiratory complications and even death.
Nasogastric (NGT) and nasoenteric tubes (NET) are essential tools for delivering enteral nutrition and medication to patients with swallowing difficulties. However, an integrative review of scientific literature reveals that adverse events related to these tubes are relatively common. These complications are generally categorized into mechanical issues and other secondary injuries. Mechanical complications include tube obstruction, esophageal or pharyngeal issues, intestinal or intracranial perforation, and unplanned removal. Other risks include pressure injuries from tube fixation and dangerous misconnections.
The most severe risks involve the respiratory system. Research indicates that up to 3.2% of NGT/NET insertions in the USA have been placed into the airway, potentially leading to pneumottothorax and death. The FDA reported 51 cases of pneumothorax related to tube placement between January 2012 and July 2017, many of which required urgent interventions like chest tube insertion. Such errors can lead to increased morbidity, prolonged hospital stays, and higher mortality rates.
Data from the United Kingdom highlights the scale of the procedure and its associated risks. The National Patient Safety Agency (NPSA) estimates that approximately 170,000 NGT/NET insertions occur annually in the UK for nutrition and medication. Between 2005 and 2010, the UK National Reporting and Learning System recorded 21 deaths and 79 severe adverse events specifically caused by tube displacement. Beyond life-threatening errors, patients may also experience sinusitis, nasal septum erosion, epistaxis, or nasopharyngeal discomfort.
Source: Tricky Topics in Nursing - Nasogastric Tube Insertion
