How is ng tube inserted

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. Gloves must be worn while starting an NG; and if the risk of vomiting is high, the operator should consider face and eye protection as well as a gown.

Trauma protocol calls for all team members to wear gloves, face and eye protection and gowns. This advice does not apply to neonates preterm to 28 days. Note that taking proton pump inhibitors or H 2 receptor antagonists may alter the pH.

Similarly, intake of milk can neutralise the acid. This involves taking a chest X-ray including the upper half of the abdomen. The tip of the tube can be seen as a white radio-opaque line and should be below the diaphragm on the left side. This test is mentioned here for historic interest only. Also known as the whoosh test, it has been shown to be an unreliable method of checking tube placement, and the NPSA ; a; b has said that it must no longer be used.

There are several advantages associated with the use of NG tubes. They will decompress the stomach by releasing air and liquid contents. This is important for patients with ileus, intestinal and gastric outlet obstruction. These conditions can cause vomiting, and patients are at risk of aspirating their stomach contents, which can lead to potentially lethal pneumonitis. Nasogastric tubes may also be useful for feeding patients who have dysphagia, for example after experiencing a stroke, and also for those being who have undergone a tracheostomy.

Nasojejunal tubes are longer versions of NG tubes. They are inserted under endoscopic guidance to lie further in the jejunum and may be useful in feeding patients with pancreatitis. Nursing Times Jobs has thousands of current vacancies - start your job search today! Dougherty, L. Chichester: Wiley Blackwell. Earley, T. Nursing Times; 38, Once the tube placement has been confirmed, mark with a permanent marker and record the length of tubing extending from the nose to the outer end of the tube.

This aids in timely recognition and identification of tube displacement or migration. This keeps the NG tube in place. Document the procedure according to agency policy, and report any unexpected findings to the appropriate health care provider. Timely and accurate documentation promotes patient safety. An order is required to remove an NG tube.

Supplies include waterproof pads, 20 ml syringe, tissues, non-sterile gloves, and garbage bag. Verify patient using two identifiers. Follow agency policy for proper patient identification. Perform hand hygiene. This reduces the transmission of microorganisms. Disconnect tube from feed if present. This prevents risk of aspiration of tube feed. Disconnect tube from feed or suction.

Remove tape or securement device from nose. This allows for the tube to be easily removed. This allows for tube to be easily removed.

Clear NG tube by inserting 10 to 20 ml of air into tube. This prevents aspiration of tube feed falling out of tube. Insert 10 to 20 ml of air into NG tube. Instruct patient to take a deep breath and hold it. This prevents aspiration; holding the breath closes the glottis. Kink the NG tube near the naris and gently pull out tube in a swift, steady motion, wrapping it in your hand as it is being pulled out. Dispose of tube in garbage bag. This prevents any residual feed from flowing out of tube upon removal.

Pull out tube in a swift, steady motion Wrap tube in glove and dispose as per agency policy. Offer tissue or clean the nares for the patient and offer mouth care as required. Offer tissue or clean the nares for the patient. Remove gloves and place patient in a comfortable position. This promotes patient comfort and reduces the transmission of microorganisms. To provide feeding of nutrients into stomach or feeding directly into small intestine with a long, thin, flexible enteral feeding tube.

Esophageal abnormalities, such as recent caustic ingestions, diverticula, or stricture, because of a high risk of esophageal perforation. Nasogastric tube for decompression such as a Levin tube single lumen or Salem sump tube double lumen such that second lumen vents to atmosphere. If small intestine feeding planned, a long, thin, intestinal feeding tube nasoenteric tube for long-term enteral feeding use with a stiffening wire or stylet.

Topical anesthetic spray such as benzocaine or lidocaine. Vasoconstrictor spray such as phenylephrine or oxymetazoline. When placing a smaller, more flexible intestinal feeding tube, a wire or stylet is used to stiffen the tube. These tubes usually require fluoroscopic or endoscopic assistance for passage through the pylorus. If patient is ventilated through an endotracheal tube that protects the airway, the nasogastric tube can be placed with patient upright or, if needed, supine.

Nasal turbinates can block the nasal passage. There is usually adequate space below the inferior turbinate to pass the nasogastric tube. Check for patency of each nostril by holding one closed and asking patient to breathe through other nostril. Ask patient which provides better airflow. Choose the side for tube insertion and spray topical anesthetic in this nostril and the pharynx at least 5 minutes before tube insertion.

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.

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. 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.