Download - PSO-HNS

CONCLUSION & RECOMMENDATIONS: discarded as a routine procedure requiring no preliminary
knowledge of the area of insertion. For
The important findings in this study are the medical clerks, interns, resident physicians and
summarized as follows: even the specialists aspiring for quality medical care,
may this simple advise on nasogastric intubation
1. There is a higher prevalence of sinusitis be a symptom-free experience for the patients and
among patients with nasogastric tube than a trouble-free procedure for the physicians.
those patients without it. Sinusitis was noted
to occur in 76.47% of patients with NGT
in this study. The risk of developing REFERENCES:
sinusitis secondary to NGT is 4 times
greater than those patients without NGT. 1. Becker SP: Anatomy for Endoscopic Sinus
Surgery. In Endoscopic Sinus Surgery. The
2. Sinusitis in patients with NGT developed Otolaryngologic Clinics ofNorthAmerica, edited
between 3 to 11 days with a mean of 6.63 by Friedman, M. 22:677-682. Aug. 1989.
days. As the duration of nasogastric tube 2. Caplan E, Hoyt N: Nosocomial Sinusitis.
Journal of American Medical Association.
is prolonged more patients develop sinusitis. 247:639-641. Feb. 1982.
3. Dretmer B; Johansson P; Kumlien J: Experimen-
3. the risk of developing sinusitis is greater tally induced sinusitis: the imlxmance of
if the NGT is placed on the deviated portion vasomotor regulation. Archives of ORL-HNS.
of a deviated nasal cavity. 246 (5); p. 315-317. 1989.
4. Evans FO Jr., Sydnor A Jr., Moore WE et al:
In light of the results of this study, the following Sinusitis of Maxillary Antrum. New England
points are recommended: Journal of Medicine. 293: 735, 1979.
5. Knodel A, Beckman J: Unexplained Fever in
1. Nasal examination should be done prior to patients with Nasotracheal Intubation. Journal
nasogastric intubation to determine side of of American Medical Association. 248:868-
septal deviation, if present, and to take note 870. Aug. 1982.
of other obstructivetissue such as enlarged 6. Levy C; Meye P; Guerin JM; Deberardinis
F; Aouala D:Nasocomial sinusitis inan intensive
turbinates. The medical clerks, interns, care unit. Role of nasotracheal intubation. Ann.
and residents should know this basic step. Otolarygol Chir Cervicofac. 105 (7)p 549-552.
2. Since sinusitis among patients with NGT 1988 (MEDLINE).
is noted to occur on the average on the 7. Linden B, Aguilar E, Alien S: Sinusitis in
6th day, physicians are cautioned not to Nasotraceally lntubated patients. Archives of
prolong the stay of the NGT in one nasal Otolaryngology Head & neck Surgery. 114:860-
cavity. If this is not possible, a change of 861. Aug, 1988/
NGT site to the other nasal cavity on the 8. Mackay I, Cole P: "Phinitis, sinusitis and
6th or 7th day is recommended, asscoiated Chest Disease". In Scott Brown's Oto-
3. If nasal examination showed deviated laryngology: Rhinology. 5th ed., edited by
nasal septum, putting the NGT in the Mackay & Bull. Butterworth & Co. pp. 73-
deviated side is not recommended. If 77, 1987.
9. Malow JB, Creticos CM: "Nonsurgical
NGT is indicated, put the NGT in the Treatment of Sinusitis". In Otolaryngologic
nondeviated side. Clinics of North America. 22:809-817. Aug.
4. The attending physicians (especially the 1989.
neurologist) who deals with a comatose 10. Rhys Evans PH.: "Anatomy of Nose and
patient are advised to be more aware with Paranasal sinuses". In Scott Brown's Otolarynthe
problem. For any unexplained signs and gology: Basic Sciences. 5thed., editor by David
symptoms of infection such as fever W. pp 138-160 Butterworths & Co. 1987.
and leucocytosis, 5the NGT causing sinusi- 11. Stammberger H., Wolf O.: headaches and Sinus
tis could be the culprit. Disease, the Endoscopic Approach. Arch. of
Otolaryngotogy Head and Neck Surgery-supple-
Nasogastric intubation should not therefore be ment. pp 3-22, 1986.
45