NASOGASTRIC TUBE INSERTION
Be alert to the risk of tracheobronchial
• To provide information about NGT
insertion, including the purpose of the
procedure, potential complication and the
steps involved in performing the
procedure, information for patient and/or
family education.
OBJECTIVES:
• After reviewing this information, the
students should be able to:
• 1. State the uses for an NGT
• 2. Discuss patient conditions that must be
met in order for an NGT to be inserted.
• 3. Identify complications of improper
NGT placement.
• 4. Describe the procedure for inserting an
NGT in the adult patient.
DEFINITION:
• it is a flexible tube that provides access to
the stomach through the nose.
• Commonly used types of NGT are the
• Levin tube and Salem sump tube
PURPOSE:
1. To decompress the stomach by removing
fluids or gas to promote abdominal
comfort.
2. To allow surgical anastomoses to heal
without distention.
3. To decrease the risk of aspiration.
4. To administer medications to clients.
5. To provide nutrition.
6. To irrigate the stomach and remove toxic
substances.
RED FLAGS:
1. Limit insertion of an NGT from patients
recovering from gastric, nasal or
craniofacial surgery.
2. Do not instill any liquids through NGT or
connect it to suction until its placement its
placement in the stomach has been
confirmed.
3.
aspiration, nasal erosion, esophagitis and
gastric ulcers.
4. Carefully monitor patients with NGT and
with altered level of consciousness and
are unable to protect their airway.
MATERIALS NEEDED:
• Nasogastric tube, Asepto syringe,
lubricating jelly, gloves, tape ,cup of
water with straw, stethoscope, lidocaine
spray, personal protective equipment.
PRE-PROCEDURE STEPS:
1. Review facility /unit protocol for
inserting an NGT
2. Review the doctors order.
3. Review the patients medical
history/medical record.
4. Advised the patient that he/she may feel
discomfort.
5. Explain that he /she will be given a cup of
water to sip or chips once the tube reaches
the pharynx
6. Ask the patient to identify a signal that
he/she will use to communicate with you.
7. Perform laboratory testing to monitor cbc,
pt and ptt
PROCEDURE STEPS:
1. Assess the patients to determine if the
patient meets criteria for NGT placement.
2. Assess mental status.
3. Assess the patient’s nares.
4. Use a penlight to inspect for anatomical
abnormalities.
5. Ask the patient to breathe through his/her
nose and occlude one nostril at a time
6. Select the larger nares to ease insertion
7. Examine each nostril in order to
determine the most patent opening and
check for lesions or obstruction.
8. Check the condition of the NGT for defects
such as rough edges.
9. 9Stand on patient’s right side if you are right
handed, on left side if you are left handed
because you will you your dominant hand.
10. obtain the patients verbal consent prior to
beginning of procedure.
 11. Position and drape the patient for privacy NURSING CONSIDERATIONS:
12. The patient should be placed in a High-
Fowlers position with pillows behind the 1. NGTs may be inserted for variety of
shoulders. therapeutic or diagnostics purposes.
13. .Determine which nostril is more patent. 2. Prior to placing an NGT,assess the
14. Measure the length of the tube from the patient to determine if he or she meets the
bridge of nose to the earlobe to the xiphoid criteria of placement.
process and indicate with a piece of tape on 3. Complications associated with the use of
the tube an NGT can range from minor(such as
15. If the client is conscious and alert,have him nasal irritation,epistaxis and sinusitis) to
or her swallow or drink water. more severe.
16. .Lubricate the tip of the tube with water 4. NGT insertion is usually a BLIND
soluble lubricant. procedure using clean,not sterile
17. .Gently insert the tube into the nasopharynx technique.
and advance the tube.
18. when the tube nears the back of the throat,
instruct the patient to swallow or drink sips
of water(unless contraindicated).If resistance
is met, then slowly rotate and aim the tube
downward and toward the closer ear; In the
intubated or semi-conscious client, flex the
head toward the chest while passing the
tube.

PATIENT AND FAMILY EDUCATION:

1. Inform the patient that the presence of an

NGT can be mildly uncomfortable but
should not be painful or cause breathing
difficulties, coughing, choking ,vomiting
or skin breakdown. Alert the primary
clinician if these signs/symptoms occur.
2. Educate the patient to request assistance
when changing positions or getting
out of bed to avoid dislodging the tube.

USES OF NGT:

1. Administer fluids, medication and other

substances when oral administration is not
viable.(GAVAGE)
2. Remove stomach contents.(LAVAGE)
3. Decompress the stomach to prevent
aspiration of the stomach contents when
peristalsis is impaired.
4. Treat gastric or esophageal hemorrhage.
5. Provide diagnostics information, how to
evaluate for diaphragmatic rupture or
gastric contents for analysis.