NASOGASTRIC TUBE INSERTION
DEFINITION
Nasogastric tube that is passed through the nose and down the nasopharynx and esophagus into the stomach.
It can be used to remove the contents of the stomach, including air, to decompress the stomach, or to remove
small solid objects, and fluid, such as poison, from the stomach.
INDICATIONS
- Decompress the stomach
- Obtain collection the gastric contents
- Treatment of gastric immobility, bowel obstruction
- Prevention of vomiting’s and aspiration
- Assessment of GI tract and GI bleeding
EQUIPMENTS:
- Personal protective equipment
- NG Tube
- Catheter tip irrigation 60ml syringe
- Xylocaine gel
- Stethoscope
- Adhesive tape
- Cup of water
- Emesis basin
- PH indicator strips
PROCEDURE
- Collect the equipment
- Explain the procedure to patient
- Positioning to the patient (Sitting position or upright position)
- Examine the nostrils for deformity/ obstructions to determine best side for the nsertion
- Measure tubing from bridge of nose to earlobe, then to the point halfway between the end of the
sternum and the navel.
- Lubricate 2-4 inches of tube with lubricant (preferably 2% Xylocaine). This procedure is very
uncomfortable for many patients, so a squirt of Xylocaine jelly in the nostril, and a spray of
Xylocaine to the back of the throat will help alleviate the discomfort.
- Pass tube via either nare posteriorly, past the pharynx into the esophagus and
then the stomach.
- Instruct the patient to swallow (you may offer ice chips/water) and advance the tube as the patient
swallows. Swallowing of small sips of water may enhance passage of tube into esophagus.
- Withdraw tube immediately if changes occur in patient's respiratory status, if
tube coils in mouth, if the patient begins to cough or turns pretty colours
- Check for placement by attaching syringe to free end of the tube, aspirate sample of gastric contents.
Do not inject an air bolus, Obtain an x-ray to verify placement before instilling any
feedings/medications or if you have concerns about the placement of the tube.
- Secure tube with tape or commercially prepared tube holder.
- Document and reporting the procedure.
COMPLICATIONS
- Tissue trauma
- Vomiting
- Gagging sensation
- Suctioning it happening
NASOGASTRIC TUBE FEEDING
A nasogastric tube (NG tube) is a special tube that carries food and medicine to the stomach through the
nose. It can be used for all feedings or for giving a person extra calories.
PURPOSE
- To provide adequate nourishment
- To administer medication
- To provide feed to patient through surery patients, unconscious patients etc.
INDICATIONS
- Head to neck surgery
- Coma
- Obstruction of esophagus
- Severe aneroxia nervosa
- Recurrent episodes of aspiration
- Increased metabolic needs
- Poor oral intake
EQUIPMENTS
- Formula feed
- Graduated container
- Large syringe
- Water in container
- Stethoscope
- Feeding liquid
- Kidney tray and paper bag
- Small towel
PROCEDURE
- Identify the patient and explain the procedure
- Feed will give around 10 to 20 minutes
- Assess food allergies time of last feed
- Place the container with feed in warm water
- Wash the hands
- Positioning to the patient (Fowler’s position)
- Spread the towel over to patient chest
- Wear PPE kit
- If tube placement is confirmed in stomach, pinch the feeding tube and attach barrel of feeding
syringe to tube
- One feed will give only 100 ml
- Pinching of feeding tube prevents air form entering the stomach and causing distention.
- After feeding is completed, flush with 40cc of plain water
- Rinse equipment’s with warm water and dry.
- Keep head of bed elevate for 0-60 mins after feeding.
- Document and reporting to the procedure
COMPLICATIONS
- Vomiting
- Numbness of GI tract
- Gagging of stomah
