Although often considered an innocuous procedure, bedside placement of a feeding tube can cause serious and even fatal complications.1–3 Although styleted small-bore tubes are most often associated with complications, large-bore tubes without stylets are not without risk.1,4–6 In a study7 of 9931 blindly inserted narrow-bore nasoenteric tubes, 1.9% were placed in the tracheobronchial tree; of the 187 tube misplacements, 35 cases of pneumothoraces (at least 5 of which resulted in a patient’s death) occurred. In rare situations, feeding tubes may also be inadvertently positioned in the brain, especially in patients with a traumatic defect.4,8–10 Risk for aspiration is greatly increased when a feeding tube’s ports end in the esophagus.1,11
Noting signs of respiratory distress:
Measuring pH and assessing appearance of the aspirate:
Listening over the...