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CONTRAINDICATIONS:Nasogastric tubes are contraindicated or used with extreme caution in people withparticular predispositions to injury from tube placement. These may include:Patients with sustained head trauma, maxillofacial injury, or anterior fossa skullfracture. Inserting a NG tube blindly through the nose has potential of passingthrough the criboform plate, thus causing intracranial penetration of the brain.Patients with a history of esophageal stricture, esophageal varices, alkali ingestionat risk for esophageal penetration.Comatose patients have the potential of vomiting during a NG insertion procedure,thus require protection of the airway prior to placing a NG tube.NASOGASTRIC TUBE FEEDINGPurpose To feed the patient with fluid diet via a nasogastric tubeRequisites Tray containingRyles tube ,Kidney trayMeasured volume of waterPrescribed feed - Ensure/Glucerna50ml syringe / 20ml syringeBlue litmus paperA StethoscopeProtective materials - White towelProcedureActionPlace the patient in semi to high fowler’s position or a lateral if patient cannot bepropped up.Rationale To prevent gastric discomfort or regurgitation of feed.Remove spigot from the nasogastric tubeActionAspirate stomach contents gently with 50ml syringe and with test with blue litmuspaper.Rationale To conform the position of the tube and note the residual amount. If the tube is inthe stomach the blue litmus paper change red.ActionObserve the nature of aspirate for color, volume and presence of blood.Rationale To exclude the malabsorption of previous feed and review feeding regime if necessary.ActionAttach funnel / Syringe to the tube and hold it to the side, at the level of thepatient’s forehead.Rationale
 
If the syringe is held too high, it increases the pressure at which the fluid enters thestomach.ActionFill the funnel/ syringe with the prescribed feed, allowing it to flow in by gravity.ActionDo not allow the funnel to become empty.Rationale To prevent gastric distention during feeding.ActionObserve the nature of aspirate for color, volume and presence of blood.Rationale To exclude the mal absorption of previous feed and review feeding regime if necessary.ActionObserve the patient during feed.Rationale To detect any adverse reaction to the feeding.ActionConclude feed with water.Rationale To keep the lumen of tube feeding.ActionDisconnect the apparatus and spigot the tube.Rationale To prevent backflow and leakage.ActionRecord the type and amount of feed and water given.Gastric lavageIs the aspiration of stomach contents and washing out of the stomach by means of alarge bore gastric tubeContraindicated1. After acid or alkali ingestion2. Seizure3. After ingestion of hydrocarbon or petroleumdistillates4. Dangerous after ingestion of strongcorrosive agentPurpose:1. For urgent removal of ingested substance to decrease systemic absorption2. To empty the stomach after endoscopic procedure3. To diagnose gastric hemorrhage and to rest hemorrhage.Equipmento Large bore levin tube or large bore ewald tube
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