title: Emergency physicians' practices and attitudes regarding procedural anaesthesia for nasogastric tube insertion.
abstract: OBJECTIVE
  To determine practice and attitudes of emergency physicians regarding procedural anaesthesia for nasogastric tube insertion (NGT).
  
  
  METHODS
  Survey of resident/attending emergency physicians working in a tertiary care medical centre.
  
  
  RESULTS
  Of 68 physicians, 46 responded: 98% believed that awake and alert patients find NGT insertion uncomfortable/painful; 93% used measures to reduce this, most commonly lubricant gel, topical anaesthetic spray, lidocaine gel, and distraction/use of a child life worker; 28% believed these provided adequate pain control and 37% believed they were inadequate. Topical anaesthetic spray, lidocaine gel, and nebulised/atomised anaesthetics were believed the most practical to administer and 44% actually used these. Nebulised/atomised anaesthetics, systemic anxiolytics, and topical anaesthetic spray were believed the most effective at pain control but only 24% actually used these. While 39% of respondents were satisfied with their current practice, 46% were dissatisfied: 91% would change their practice if new literature were to show a convenient way to effectively reduce this pain.
  
  
  CONCLUSIONS
  Emergency physicians do not actually use the measures they believe are most practical/most effective at reducing the pain associated with NGT insertion. Thus, there may be a barrier to the use of these measures. Improvement in procedural anaesthesia for NGT insertion in emergency departments is needed and desired by emergency physicians.
authors.affiliation: Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
authors.forename: G A
authors.initials: GA
authors.lastname: Juhl
authors.forename: G P
authors.initials: GP
authors.lastname: Conners
mesh_terms: D000287:Administration, Topical; D000758:Anesthesia / Q000379:methods*; D000777:Anesthetics / Q000008:administration & dosage; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D004630:Emergencies; D004635:Emergency Medicine / Q000592:standards*; D005782:Gels; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000523:psychology* / Q000592:standards; D008012:Lidocaine / Q000008:administration & dosage; D010146:Pain / Q000517:prevention & control
chemical_list: D000777:Anesthetics; D005782:Gels; D008012:Lidocaine