Punctured lung via OG tube with intubated patient?

How likely is it to puncture a lung by inserting an OG tube in an intubated patient?
Very, very unlikely without someone using a hugely inappropriate amount of force. Most pneumothoraces in the intubated patient are iatrageniocally caused by mechanical ventilation.

Not very. You would need a lot of force. You would also have to puncture and go through the cuff of the ETT. The minute you did that the vent alarm would start going off.

Quote from AlfordHow likely is it to puncture a lung by inserting an OG tube in an intubated patient?

You would think there'd be a lot of coughing, but I once inserted a small bore feeding NGT on an awake, alert patient. The patient coughed once or twice, nothing dramatic, and I hit resistance before I hit the mark I expected I'd be able to advance it. XR showed it in the right lung, no question.With that being said there was no pneumothorax, and I think you'd have to hit resistance and be quite forceful to cause one in this manner.

Yes, but it sounds like that was in an unintubated patient. There's no doubt you can put an NG in the lung, but getting past the inflated cuff an an ETT would be, uh, IMPRESSIVE....To amend my earlier statement, I don't think its impossible, but I'd say the odds are only slightly better than the odds that the 16 YOF who is crowning really WASN'T having sex.

I didn't think it was likely, just trying to think of every possibility as to why the patient who arrested and subsequently intubated was only able to have a PO2 of 49, despite being on a PEEP of 12.

There's lots of reasons why that could happen, not the least of which is pulmonary emboli. If a patient has those, you can conceivably blow all the oxygen in the world into those lungs and it may not get out of the lungs and into circulation.Off the top of my head I can't think of more reasons, but I know there are.

Quote from AlfordI didn't think it was likely, just trying to think of every possibility as to why the patient who arrested and subsequently intubated was only able to have a PO2 of 49, despite being on a PEEP of 12.

Thanks, MomRN. I'm a former CVICU RN, but I was having brain freeze today and didn't feel like making more of an effort.

Quote from JulieCVICURNThanks, MomRN. I'm a former CVICU RN, but I was having brain freeze today and didn't feel like making more of an effort.

Quote from ckh23Not very. You would need a lot of force. You would also have to puncture and go through the cuff of the ETT. The minute you did that the vent alarm would start going off.