Auscultate for bowel sounds. Patient must be able to follow instructions related to NG insertion to allow for passage of tube through nasal and gastrointestinal tracts. Check appropriate orders relevant to patient safety. This should be commensurate with the reason for the NG tube.
This allows the NG tube to pass more easily through the nasopharynx and into the stomach. Raise bed to a comfortable working height. This helps prevent biomechanical injury to the health care provider. Agree on a signal the patient can use if they wish you to pause during the procedure. This procedure can be anxiety-provoking and uncomfortable for many patients. Providing a means for the patient to communicate discomfort and a desire to pause during the procedure helps alleviate anxiety.
Nasal and oral secretions may be evident during the procedure. Provide patient with drinking water and a straw if the patient is not fluid restricted. Sipping water through a straw helps to initiate the swallowing reflex and facilitate passing of NG tube.
You will use your dominant hand to insert the tube. Measure distance of the tube from. This determines the appropriate length of NG tube to be inserted. Never use non-water-soluble lubricant e. Apply clean non-sterile gloves. Using gloves decreases the transfer of microorganisms. Colour-coded pH paper is usually used, as an initial and interim check, to confirm that acidic contents are present. Then an X-ray is taken to confirm placement prior to using NG tube for feeding.
If the pH is more than 6, it may indicate the presence of respiratory fluids or small bowel content, and the tube should be removed. An NG tube should be removed if it is no longer required. The process of removal is usually very quick. Prior to removing an NG tube, verify physician orders. During the trial, the patient should not experience any nausea, vomiting, or abdominal distension. Skip to content Chapter Tubes and Attachments.
You are inserting a nasogastric tube and the tube is not advancing. Explain your next steps, with rationale. Your patient has a nasogastric tube and is requesting water because her throat feels dry. Describe your next actions. Previous: Next: Share This Book Share on Twitter. Disclaimer: Always review and follow your hospital policy regarding this specific skill.
Safety considerations: Perform hand hygiene. Check room for additional precautions. Introduce yourself to patient. Confirm patient ID using two patient identifiers e. This enables you to drain gastric contents, decompress the stomach, obtain a specimen of the gastric contents, or introduce a passage into the GI tract. This will allow you to treat gastric immobility, and bowel obstruction. In trauma settings, NG tubes can be used to aid in the prevention of vomiting and aspiration, as well as for assessment of GI bleeding.
NG tubes can also be used for enteral feeding initially. Nasogastric tubes are contraindicated in the presence of severe facial trauma cribriform plate disruption , due to the possibility of inserting the tube intracranially. As a result, although the tip of the NG tube is likely to be within the fundus of the stomach, the aperture through which feed is excreted is most likely still within the oesophagus.
NG tubes which are not inserted to an adequate length can result in oesophageal reflux of feed and potentially aspiration.
This NG tube would need inserting further and re-assessing with a repeat X-ray to ensure placement was adequate. If the tip of an NG tube is not clearly visible , you should discuss with the on-call radiologist who may advise:. We have provided an example of how you might present your findings after reviewing the position of an NG tube on a chest X-ray.
The chest X-ray view is adequate and the NG tube can be seen bisecting the carina and remaining in the midline to the level of the diaphragm. The tip of the nasogastric tube is visible below the left hemidiaphragm and is 10cm beyond the gastro-oesophageal junction.
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