Abstract

Nasogastric tube insertion is a procedure routinely performed in wards, emergency care, intensive care unit and operation theatre etc. In a conscious patient, confirmation of its position after placement is easy with high success rate. In contrary, the failure rate for NG insertion in an intubated patient is high. Although rare, there is a possibility for its malposition into the lungs in an intubated patient. We present a case in which a nasogastric tube was inserted following endotracheal intubation, which malpositioned into the lungs causing anesthesia workstation to malfunction.

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