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NGT

NASOGASTRIC TUBE INSERTION

ANATOMY .

It will also allow for drainage and/or lavage in drug overdosage or poisoning. or introduce a passage into the GI tract. decompress the stomach. obtain a specimen of the gastric contents. you are gaining access to the stomach and its contents. and bowel obstruction. This will allow you to treat gastric immobility.Indication By inserting a nasogastric tube. This enables you to drain gastric contents. In .

. In this instance. an orogastric tube may be inserted.Contraindications Nasogastric tubes are contraindicated in the presence of severe facial trauma (cribriform plate disruption). due to the possibility of inserting the tube intracranially.

 Complications  The main complications of NG tube insertion include aspiration and tissue trauma. Placement of the catheter can induce gagging or vomiting. . therefore suction should always be ready to use in the case of this happening.

face and eye protection and gowns. Trauma protocol calls for all team members to wear gloves. the operator should consider face and eye protection as well as a gown. Gloves must be worn while starting an NG. and if the risk of vomiting is high.Universal precautions: The potential for contact with a patient's blood/body fluids while starting an NG is present and increases with the inexperience of the operator. .

preferably 2% Xylocaine jelly Adhesive tape Low powered suction device OR Drainage bag Stethoscope Cup of water (if necessary)/ ice chips Emesis basin         . Basic equipment includes:  Personal protective equipment NG/OG tube Catheter tip irrigation 60ml syringe Water-soluble lubricant. assembled and available at the bedside prior to starting the NG tube. Equipments:  All necessary equipment should be prepared.

sit patient upright for optimal neck/stomach alignment  Examine nostrils for deformity/obstructions to determine best side for insertion  Measure tubing from bridge of nose to earlobe. This procedure is very uncomfortable for many patients. so a squirt of Xylocaine jelly in the nostril. then to the point halfway between the end of the sternum and the navel  Mark measured length with a marker or note the distance  Lubricate 2-4 inches of tube with lubricant (preferably 2% Xylocaine). and a spray of Xylocaine to the back of the throat will help alleviate the discomfort. .PROCEDURE:  Don non-sterile gloves  Explain the procedure to the patient and show equipment  If possible.

 If resistance is met.   Instruct the patient to swallow (you may offer ice chips/water) and advance the tube as the patient swallows.Pass tube via either nare posteriorly. past the pharynx into the esophagus and  then the stomach. if  tube coils in mouth. rotate tube slowly with downward advancement toward closes ear. Swallowing of small sips of water may enhance passage of tube into esophagus. Do not force. Withdraw tube immediately if changes occur in patient's respiratory status. if the patient begins to cough or turns pretty colours   Advance tube until mark is reached .

aspirate sample of gastric contents. set machine on type of suction and pressure as prescribed. The pH should be below 6. remove syringe from free end of tube. and the effectiveness of the intervention.  Secure tube with tape or commercially prepared tube holder  If for suction.  . Check for placement by attaching syringe to free end of the tube. as the best practice is to test the pH of the aspirated contents to ensure that the contents are acidic. the nature and amount of drainage. Do not inject an air bolus. type & size of tube. the type of suction and pressure setting if for suction.  Document the reason for the tube insertion. the nature and amount of aspirate. connect to suction. Obtain an x-ray to verify placement before instilling any feedings/medications or if you have concerns about the placement of the tube.

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Thank you .