Critical Care, GI, Improving Outcomes, Mythbusting

The Notorious N. G. T.

I’m not sure what is more appalling – that in 2010-2012, there were 386 patients who had a nasogastric tube inserted to evaluate for GI bleeding, or that it needs to be published in 2015.  I thought REBEL EM had killed off this dinosaur, but apparently not.

Fortunately, the authors come to realistic conclusions.

In this retrospective study, patients that were admitted with melena to the surgical service had an NG tube placed.  72% of them (279 of 386 patients) had a negative aspirate.  The negative predictive value of a negative aspirate?  Less than one percent. To quote the authors:

“Most patients who initially presented presented with melena and were found to have upper GI bleeding had a negative nasogastric aspirate…

Insertion of a nasogastric tube does not affect the clinical decision to perform upper endoscopy and should not be routinely carried out.”




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