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Nasogastric (NG) Tube Insertion

 

Protocol number: GEN-003
Description:Nasogastric (NG) Tube Insertion
Date implemented: April 04, 2005
Last revision date: implementation
OMD:
Reviewed Date/By:

 
INTRODUCTION:
 
Insertion of an NG tube is the placement of a specialized catheter through the nose, down the esophagus, and into the stomach to remove stomach contents.
 
INDICATIONS:
 
NG tube insertion is indicated when evacuation of stomach contents, such as air or food, is required.  An NG tube may also be inserted to dilute or lavage ingested poisons or to remove blood when the patient has gastrointestinal hemorrhage.  Also patients who are intubated (endotracheal tube) and ventilated should receive an NG tube.
 
CONTRAINDICATIONS:
 
  • Severe Facial Trauma
  • Croup
  • Epiglottitis
 
EQUIPMENT:
 
  • NG Tube
  • 50-ml irrigation syringe
  • Water-soluble lubricant
  • Tape
  • Saline for irrigation
  • Emesis basin
  • Gloves
 
PROCEDURE:
 
  • Assess the need for NG tube insertion.
  • Use BSI.
  • Assemble the needed equipment
  • Explain the procedure to the patient.
  • If possible have the patient sit up.
  • Give the patient a handful or tissues or towel because the procedure may cause tearing.
  • Look at the nose for deformity or obstruction that may make it difficult to insert the NG tube.  Determine the best side for insertion, usually the patient’s right nostril.
  • Measure the tube from the patient’s earlobe to the tip of the nose.  Then measure from the earlobe to the bottom of the xiphoid process.  Total these two measurements and mark the correct length on the tube with tape.
  • Lubricate 6 to 8 inches of the tube with water-soluble gel.
  • Insert the tube in one of the nostrils and gently advance it toward the posterior nasopharynx.  It is easiest if you direct the tube toward the patient’s ear.
  • When you feel the tube at the nasopharyngeal junction, rotate it 180 degrees inward toward the other nostril.  Gently advance the tube until it is in the nasopharynx.
  • As the tube enters the oropharynx, instruct the patient to swallow.
  • Pass the tube to the predetermined point (DO NOT FORCE)
  • Check the placement of the tube by two methods:  aspirate gastric contents; and place a stethoscope over the epigastric region and auscultate while injecting 20-30 ml of air into the tube.
  • Tape the tube in place and connect to suction.
 
Document the procedure, including the following:  size of tube, degree of difficulty, tube placement checked, complications, and who did procedure.
 
  
 
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