Decreasing Pain and Discomfort associated with Nasogastric Tube placement Utilizing Oxymetazoline-Tetracaine and Interdisciplinary Collaboration-Decreasing Pain and Discomfort Associated with Nasogastric Tube Placement Utilizing Oxymetazoline-Tetracaine and Interdisciplinary Collaboration

Decreasing Pain and Discomfort Associated with Nasogastric Tube Placement Utilizing Oxymetazoline-Tetracaine and Interdisciplinary Collaboration

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Video Summary

Cincinnati Children’s Hospital presented a multidisciplinary quality-improvement project to reduce pain and anxiety during nasogastric (NG) tube placement in pediatric patients. The team formed an NG Numbing Spray Task Force including nurses, child life specialists, APPs, pharmacy, educators, and outcomes staff. They introduced intranasal oxymetazoline-tetracaine, a combination of a decongestant and topical anesthetic, for patients age 6 and older. The project emphasized staff education, child life assessment for appropriateness, standardized order sets, and ensuring timely medication availability. Early barriers included provider awareness, pharmacy delays, and workflow changes, which were addressed through education and stocking the spray on the unit. From December 2021 to January 2023, 25 patients were included. Results showed 92% of patients, caregivers, and staff rated the experience as excellent, good, or neutral, with narrative feedback describing less pain, distress, and agitation. The team concluded that oxymetazoline-tetracaine improved patient experience and supported broader use in pediatric nasal procedures.

Keywords

nasogastric tube placement

pediatric pain reduction

anxiety management

intranasal oxymetazoline-tetracaine

quality improvement

child life support