Pediatric Case of Successful Point-of-Care Ultrasound-Guided Nasogastric Tube Placement.
J Emerg Med
; 59(2): e57-e60, 2020 Aug.
Article
em En
| MEDLINE
| ID: mdl-32456958
BACKGROUND: Nasogastric tube (NGT) placement is commonly performed in pediatric emergency care and is classically confirmed by any one of several methods, among which auscultation or aspiration and radiography comprise the currently recognized as the reference standard. Point-of-care ultrasound (POCUS) is used to confirm NGT insertion, especially in adults or prehospital patients, but reports of its use in the pediatric emergency department (ED) are still scarce. We report a case of successful POCUS-guided NGT placement in a pediatric ED. CASE REPORT: A 3-year-old male undergoing remission therapy for acute lymphocytic leukemia presented to our ED with fever and decreased appetite. Tumor lysis syndrome was diagnosed, and endotracheal intubation was required because of the need for emergency hemodialysis for hypercalcemia. Because of difficulty in guiding the tube through the nose, ultrasound-guided placement was attempted. In the transverse view over the neck below the level of the cricoid cartilage, the 10-Fr NGT was visualized under ultrasound guidance as it passed through the esophagus. Subsequently, the entry of the NGT tip into the gastric cardia was confirmed on the subxiphoid longitudinal view. A chest radiograph confirmed the presence of the NGT in the stomach. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although the utility of POCUS for NGT placement was reported in adult patients, reports of its use in pediatric cases are still few. POCUS is a real-time, noninvasive, time-saving procedure that can be a useful alternative to radiography for confirming correct NGT placement.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Cuidados_paliativos
/
Geral
Base de dados:
MEDLINE
Assunto principal:
Sistemas Automatizados de Assistência Junto ao Leito
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Intubação Gastrointestinal
Tipo de estudo:
Diagnostic_studies
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Guideline
Limite:
Child, preschool
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Humans
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Male
Idioma:
En
Revista:
J Emerg Med
Assunto da revista:
MEDICINA DE EMERGENCIA
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Japão