3. Discussion
critically ill, coma
CRITICALLY ILL, COMA, BLIND, COMPLICATIONS
The analysis of the effectiveness of different nasoenteral tube insertion techniques in coma (physiological or induced) and intubated patients is initially necessary due to the difficulty of inserting small-bowel feeding tube in a blind manner, with the patient head in the neutral position. The high rate of complications resulting from the small-bowel feeding tube insertion due to the absence of a proven safer method poses a risk to the patient.A randomized clinical trial emphasizes that the small-bowel feeding tube insertion is often a challenge for ICU professionals. Therefore, the use of instruments that help through visualization was also reported as a facilitator for tube insertion and proper small-bowel feeding tube positioning in critically ill patients, such as laryngoscopes and videolaryngoscopes. Radiological and endoscopic techniques and methods guided by electromagnetism and fluoroscopy will also be used.Therefore, it is important and necessary to offer safer care with less risk of complications based on the best available evidence for the possibility of revealing the most adequate, effective, fast and safe technique to improve the performance of this procedure.In addition, there is the possibility of characterizing nursing care based on new techniques in order to be used in clinical practice and to expand the knowledge base and skills of nurses in managing the small-bowel feeding tube insertion in critically ill patients, being an accessible and low-cost technology that can be used by nurses, streamlining work processes and contributing to adequate, safe and quality care.Results favorable to the use of different nasoenteral tube insertion methods have been described by anesthesiologists.However, it is clear that such techniques are little used by nurses in clinical practice, in addition to a gap related to the deficiency of experimental studies with high level of evidence in relation to new small-bowel feeding tube insertion techniques to aid decision-making in clinical practice, which justifies the conduction of the present study.