1/ Good morning, #MedTwitter, and happy Tuesday! We’re excited to bring you our latest installment of #ReadingRoom today. Dim the lights; it’s time to clinically correlate!
What object is labeled in the CXR below? What is it used for?
2/ That, friends, is our dear friend: the NG tube. It is our portal for tube feeds and PO meds (technically Per Nasus?), or if you put the thing down flip it and reverse it you can use the NGT to decompress the stomach.
3/ Next question: should you place that order that says “OK to use NG tube”?
The graphic below shows a systematic approach to ensure correct placement. This one is good to go!
4/ Let’s look at another NGT. This one looks a little different - how? And why? What is it?
5/ This one is distinctive because of its thick, weighted tip - a Dobhoff.
Drs. Dobbie & Hoffmeister invented the smaller, more flexible tube, and added a metal tip wrapped in silicone in an attempt to increase the chances of successful placement.
When clinicians are:
☀️ Stopped from taking what they believe to be ethically appropriate actions
☀️ Forced to take actions that are ethically inappropriate based on their professional obligations
Results in a sense of complicity & wrongdoing
3/ Moral distress occurs at:
☀️Patient or family level
☀️Unit or team level
☀️System level