title: [Ultrasound evaluation of the nasogastric tube position in prehospital].
abstract: OBJECTIVE
  To assess the feasibility and actual performance of ultrasound control in verification of the correct positioning of a nasogastric tube in pre-hospital settings.
  
  
  METHODS
  Prospective, observational, single-centre study.
  
  
  METHODS
  Correct positioning of nasogastric tubes in patients intubated in a pre-hospital setting was verified by ultrasound and routinely compared with the results of two pre-hospital tests, namely a test involving insufflation of air through a syringe coupled with epigastric auscultation and a test involving aspiration of gastric fluid with a syringe. Routine x-ray control was carried out and compared with the pre-hospital results.
  
  
  RESULTS
  Ninety-six patients were included. Mean age was 52 years (median: 53.5 years, SD: 23 years). In 83% of the patients (n=80), the nasogastric tube was located by ultrasound immediately during the insertion procedure. The mean times to ultrasound confirmation of correct positioning of the nasogastric tube were 7s (median: 2s; SD: 16s) and 19s for the syringe tests (median 19s, SD: 5s). Eight ultrasound control tests were negative. Location coupled with insufflation of air through a syringe allowed detection of the nasogastric tube in the stomach but without providing confirmation of the actual gastric position. The pre-hospital ultrasound results were confirmed by subsequent radiological controls at the hospital.
  
  
  CONCLUSIONS
  The ultrasound test performed in our study to verify correct positioning of a nasogastric tube is feasible in a pre-hospital setting. This technique is rapid and non-irradiating and is more sensitive and specific than the syringe tests commonly used in pre-hospital settings, and it may be performed in place of the latter tests.
authors.affiliation: Smur, bataillon des marins pompiers de ville de Marseille, 137, boulevard de Plombières, 13003 Marseille, France. brunpierremarie@voila.fr
authors.forename: P-M
authors.initials: PM
authors.lastname: Brun
authors.forename: H
authors.initials: H
authors.lastname: Chenaitia
authors.forename: J
authors.initials: J
authors.lastname: Bessereau
authors.forename: J
authors.initials: J
authors.lastname: Leyral
authors.forename: C
authors.initials: C
authors.lastname: Barberis
authors.forename: A-L
authors.initials: AL
authors.lastname: Pradel-Thierry
authors.forename: J
authors.initials: J
authors.lastname: Stephan
authors.forename: P
authors.initials: P
authors.lastname: Benner
authors.forename: E
authors.initials: E
authors.lastname: Querellou
authors.forename: F
authors.initials: F
authors.lastname: Topin
mesh_terms: D000328:Adult; D000368:Aged; D001314:Auscultation; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006801:Humans; D007327:Insufflation; D007441:Intubation, Gastrointestinal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D053120:Respiratory Aspiration; D013270:Stomach / Q000000981:diagnostic imaging; D013594:Syringes; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*