NASOGASTRIC INTUBATION

Meghana c
DOTT, BOTT, M.Sc Medical Biochemistry
CONTENTS

• DEFINITION
• PURPOSE
• INDICATION
• POSITION & EQUIPMENT
• PROCEDURE
• DETERMINNATION OF THAT TUBE IS IN STOMACH BY FOLLOWING
METHODS
• ADVANTAGES
• COMPLICATIONS
• CONTRAINDICATIONS
DEFINITION

It is the insertion of a tube into the oesophagus

and stomach through the nose

It is defined as the passage of single or double

lumen tube through the nose or mouth to
stomach for the purpose of the drainage,
instillation, decompression, lavage or
performance of diagnostic tests.
PURPOSE

1. To feed the patient with fluids when oral intake is not

possible
2. To dilute and remove consumed poison
3. To instill ice cold solution to control gastric bleeding
4. To prevent stress on operated site by decompressing
5. To relive vomiting and distension
6. To collect gastric juice for diagnostic puposes
INDICATIONS

1. Patient who cannot eat (GIT functioning normally)

2. Comatose patient
3. Mechanically ventilated
4. Patient who will not eat
5. Patients who refuse to eat
6. Elderly • Disoriented patients
7. Patients who cannot maintain adequate oral nutrition
8. Patients with infection, trauma, cancer, Surgery etc.
POSITION & EQUIPMENT

POSITION
Fowler's position.

EQUIPMENT
1. Nasogastric tube, of specified size
2. Clamp
3. Water-soluble lubricant
4. Glass of water or ice chips
5. Tape
6. Stethoscope
PROCEDURE

1. Explain procedure to patient.

2. Assemble equipment and examine tube for defects (rough edges or
partially closed lumens)
3. Position patient
4. Instruct patient to blow nose to clear nostrils. Use a flashlight and
occlude one nostril at a time to assess patency of nostrils before
choosing site for insertion.
5. Measure tube for placement from tip of nose to ear lobe to bottom of
xiphoid process; mark tube with tape. Note location on tube; you may
mark tube with tape or nontoxic marker.
PROCEDURE

6. Provide patient with glass of water or ice chips.

7. Lubricate tip of tube with water-soluble lubricant and begin
insertion.
8. After it reaches the nasopharynx may help to prevent tube from
entering patient's mouth. Instruct patient to take a swallow of
water or suck on ice chips once tube passes nasopharynx.
9. Keep his/her chin tucked toward chest so that the tube passes
into the stomach and not lungs.
10. Continue insertion in rhythm with swallowing until desired length
of tube is passed.
DETERMINNATION OF THAT TUBE IS IN
STOMACH BY FOLLOWING METHODS

 Place stethoscope over stomach, inject 10 mL of

air into tube and listen for air passage.
DETERMINNATION OF THAT TUBE IS IN
STOMACH BY FOLLOWING METHODS

 Gently aspirate stomach content with irrigating syringe.

Fluid from stomach or small bowel may be:-
• Green,
• Tan,
• Brown,
• Clear, yellow,
• Bloody or
• Bile-colored.
Pulmonary fluid may be:-

1. Tan
2. off white,
3. clear or pale yellow.
BY DETERMINING ASPIRED FLUID

1. Ph from stomach is 1.0 to 6.5

2. from small intestine 7.5 to 8.0
3. from the lungs over 6.0

however, none of these is fail-safe.

NOTE :
If any doubt exists, placement should be checked with X-rays. It
should be noted that chest X-ray is the only way to confirm
correct placement.
ADVANTAGES

1. An adequate amount of all types of nutrients including

distasteful foods & medications can be supplied
2. Large amount of fluids can given with safety
3. It can be continued weeks with out any danger
4. The stomach may be aspirated at any time of desired
5. Overloading of the stomach can be prevented by drip
method
THESE TUBES MAY ALSO BE ASSOCIATED
WITH THE FOLLOWING COMPLICATIONS

1. Rhinitis
2. Pharyngitis
3. Oesophageal ulceration
4. Gastric erosion
5. Increased tendency for reflux
6. Patient discomfort
7. Difficulty swallowing.
CONTRAINDICATION

1. Gastric surgery 6. recent nasal surgery

2. Ulcers 7. facial surgery
3. Tracheoesophageal 8. Deviated nasal septum
fistula 9. Patient on
4. Oesophageal surgery anticoagulant therapy
5. Polyps in nose 10.Tracheotomy