Inot, Alecks Florence T.

BSN-3A
Instructions:
❖ During your RLE exposure assist in performing NGT feeding with your patients. Then, submit a
report on the correct process in performing NGT Feeding. Highlight the nursing responsibilities
you need to perform when doing this procedure. Submit this on a PDF or MS Word Format, with
no more than 2 pages, on or before February 9, 2023. Late submissions will not be ACCEPTED.

NGT FEEDING
(NASOGASTRIC TUBE)

-A tube that is inserted through the nose, down the throat and esophagus, and into the stomach. It can
be used to give drugs, liquids, and liquid food, or used to remove substances from the stomach. Giving
food through a nasogastric tube is a type of enteral nutrition. Also called gastric feeding tube and NG
tube.
-Also, it is a procedure in which a thin, plastic tube is inserted into the nostril, toward the esophagus,
and down into the stomach. Once an NG tube is properly placed and secured, healthcare providers such
as the nurses can deliver food and medicine directly to the stomach or obtain substances from it.

STEP-BY-STEP PROCEDURE
• Put on gown, gloves, and face shield.
• Check for patency of each nostril by holding one closed and asking patient to breathe through
other nostril. Ask patient which provides better airflow.
• Look inside the nose for any obvious obstructions.
• Place a towel or blue pad over the patient’s chest to keep it clean.
• Choose the side for tube insertion and spray topical anesthetic in this nostril and the pharynx at
least 5 minutes before tube insertion. If time permits, give 4 mL of 10% lidocaine via a nebulizer
or insert 5 mL of 2% lidocaine gel into the nares.
• If available, spray a vasoconstrictor such as phenylephrine or oxymetazoline in the nostril, trying
to reach the entire nostril surface, including the superior and posterior aspects; however, this
step can be omitted.
• Estimate the proper depth of insertion—about the distance to the earlobe or angle of the
mandible and then to the xiphoid, plus 6 inches; note which of the black marks on the tube
correspond to this distance.
• Lubricate the end of the nasogastric tube.
• Gently insert the tip of the tube into the nose and slide along the floor of the nasal cavity. Aim
back then down to stay below the nasal turbinate.
• Expect to feel mild resistance as the tube passes through the posterior nasopharynx.
• Ask the patient to take sips of water through a straw and advance the tube during the swallows.
The patient will swallow the tube, facilitating passage into the esophagus. Continue to advance
the tube during swallows to the predetermined depth using the black marks on the tube as
guidance.
• Assess proper tube placement by asking the patient to speak. If patient is unable to speak, has a
hoarse voice, is violently gagging, or is in respiratory distress, the tube is probably in the trachea
and should be removed immediately.
• Inject 20 to 30 mL of air and listen with the stethoscope under the left subcostal region. The
sound of a rush of air helps confirms the tube’s location in the stomach.
• Aspirate gastric contents to further confirm placement in the stomach (sometimes no gastric
contents can be aspirated even when the tube is properly positioned in the stomach).
• Sometimes a chest x-ray is needed to definitively confirm the location of the tube in the
stomach. If the tube will be used for infusing any substances, such as a radiopaque contrast
agents or liquid feedings, a chest x-ray is highly recommended.
• Secure the tube to the patient’s nose. Apply benzoin to the skin if available. Use a 4- to 5-inch
piece of adhesive tape that is ripped vertically for half of its length and attach the wide half to
patient’s nose. Then wrap the tails of the tape in opposite directions around the tube.
• Attach the nasogastric tube to suction and set to low suction (intermittent suction if possible).

TIPS IN INSERTING NGT

✓ When inserting the nasogastric tube, it may be helpful to place your other hand behind the
patient’s head to keep him or her from pulling back.

✓ Asking the patient to take sips of water when passing the nasogastric tube through the
pharynx into the esophagus and through the esophagus into the stomach can greatly improve
the chance of success and reduce gagging. This technique allows the patient to swallow the
tube.

✓ Sometimes having the patient tuck their chin toward their chest (chin tuck) while sipping
water can help facilitate tube passage from the oropharynx into the stomach.