What is a contraindication for nasogastric intubation?

A fracture of the cribriform plate is a contraindication for nasogastric intubation because such a fracture can compromise the integrity of the skull base and increase the risk of complications. The cribriform plate is a thin bony structure located at the roof of the nasal cavity, and an injury in this area can lead to communication between the nasal cavity and the cranial cavity. Inserting a nasogastric tube could potentially introduce the tube into the cranial cavity if there is a breach in the barrier, leading to serious complications such as intracranial infections or cerebrospinal fluid leaks. This risk is particularly significant in trauma patients, where the assessment of the extent of injury may not be immediately clear. Therefore, nasogastric intubation is avoided in such cases to prevent catastrophic outcomes.