Placement of nasogastric tubes

The use of a split rubber tube passed through the nose into the oesophagus to facilitate the placement of a nasogastric tube has been described [1]. However, this technique may be associated with nasal trauma and bleeding due to the size of the rubber tube, especially if a large nasotracheal tube is required. We would suggest that rather than passing the tracheal tube through the nose, it is passed orally into the oesophagus. The nasogatric tube can then be passed nasally, retrieved in the oropharynx and then passed down the rubber tube. Once the nasogastric tube is placed, the split rubber tube can be removed and the nasogastric tube withdrawn to take up the slack in the oropharynx. This modification of the technique should reduce the incidence of trauma to the nasal passages.