What is nasogastric intubation?

Key points
1.

In nasogastric (NG) intubation, a tube is placed through

your nose into your stomach.

2.

Your healthcare provider can use an NG tube to feed you

and give you medicine.

3.

They can also apply suction to an NG tube to remove

stomach contents.
If you cant eat or swallow, you may need to have a nasogastric tube
inserted. This process is known as nasogastric (NG) intubation.
During NG intubation, your doctor or nurse will insert a thin plastic
tube through your nostril, down your esophagus, and into your
stomach. Once this tube is in place, they can use it to give you food
and medicine. They can also use it to remove things from your
stomach, such as toxic substances or a sample of your stomach
contents.

When would you need nasogastric intubation?

NG intubation is most commonly used for patients who:

have neck or facial injuries

have had neck or facial surgery
need a mechanical ventilator to breathe
have an intestinal obstruction or blockage
are comatose
Its also used to help treat some premature infants.
Your doctor or nurse can give you food and medicine through an NG
tube. They can also apply suction to it, allowing them to remove
contents from your stomach. For example, your doctor may use NG
intubation to help treat accidental poisoning or drug overdose. If
youve swallowed something harmful, they can use an NG tube to
try to remove it from your stomach or deliver treatments. For
instance, they may administer activated charcoal through your NG
tube to help absorb the harmful substance. This can help lower your
chances of a severe reaction.
Your doctor or nurse can also use an NG tube to:

remove a sample of your stomach contents for analysis

remove some of your stomach contents to the relieve the
pressure on an intestinal obstruction or blockage

remove blood from your stomach

How should you prepare for nasogastric intubation?

If you need to have an NG tube inserted, it will probably happen in a

hospital. In some cases, you may get the tube inserted at home. In
most cases, you wont need to take any special steps to prepare.

Right before its inserted, you may need to blow your nose and take
a few sips of water.

What will the procedure involve?

Your doctor, nurse, or other care provider will insert your NG tube
while youre lying down in a bed with the head elevated or sitting in
a chair. They will likely ask you to bend your head, neck, and body at
various angles as they thread the tube through your nostril, down
your esophagus, and into your stomach. These movements can help
ease the tube into position, without causing you too much pain or
discomfort. They may also ask you to swallow or take small sips of
water when the tube reaches your esophagus to help it slide into
your stomach.
Once your NG tube is in place, your care provider should take steps
to check its placement. For example, they might try to draw fluid out
of your stomach. Or they might insert air through the tube, while
listening to your stomach with a stethoscope.
To keep your NG tube in place, your care provider will likely secure it
to your face with a piece of tape. They can reposition it if it feels
uncomfortable.

What are the benefits of nasogastric intubation?

If you cant eat or drink, NG intubation and feeding can help you get
the nutrition and medications you need. NG intubation can also help
your doctor treat an intestinal obstruction in ways that are less
invasive than intestinal surgery. They can also use it to collect a
sample of your stomach contents for analysis, which can help them
diagnose certain conditions.

What are the risks of nasogastric intubation?

If youre conscious when your NG tube is inserted, you may feel

some discomfort as the tube passes through your nostril into your
stomach. If your NG tube isnt inserted properly, it can potentially
injure the tissue inside your nose, sinuses, throat, esophagus, or
stomach. Your care provider may also mistakenly thread it through
your windpipe into your lungs. If this happens, they may accidentally
pass food or medicine into your lungs. This is known as aspiration. It
can lead to pneumonia or other infections.
NG tube feeding can also potentially cause:

abdominal cramping
abdominal swelling
diarrhea
nausea

vomiting
regurgitation of food or medicine
Your NG tube can potentially become blocked, torn, or dislodged.
This can lead to additional complications. Using an NG tube for too
long can also cause ulcers or infections to develop on the tissue of
your sinuses, throat, esophagus, or stomach. If you need long-term
tube feedings, your doctor will likely recommend a gastrostomy
tube. They can surgically implant a gastrostomy tube in your
abdomen to allow your care providers to introduce food directly into
your stomach.

How can you lower your risk of complications?

To lower your risk of complications from NG intubation and feeding,
you or your healthcare provider can:

brush your teeth regularly

clean your nose frequently
tape the tube securely to your face
check the tube for signs of leakage, blockage, and kinks
elevate your head during feedings and for an hour afterwards
watch out for signs of irritation, ulceration, and infection
Ask your doctor for more information about your specific treatment
plan and outlook.

It probably will not ease as time passes, though you might find
some ways to minimize the discomfort. If the tube is placed
correctly, any discomfort is usually caused by the tube rubbing
against tissue. Occasionally the nares will become irritated from the
tube rubbing against them. If this happens, be sure the tube is
secured with tape in a position that does not cause pressure on the
nares. Similarly, the tube can rub and cause a sore throat. Sucking

on ice chips may help. Also, a numbing spray such as Cetacaine or

Chloraseptic lozenges may offer temporary relief.
- Healthline Medical Team

NASOGASTRIC TUBE FEEDING TTSH

Nasogastric tube (NGT) feeding is giving of liquid food through a tube that is inserted into the
stomach through the nose. It is recommended for a person who is unable to chew or swallow.
A. PREPARATION
1. Gather the required items:
A. Recommended feed
B. Measuring jug for feed
C. Cup to receive stomach contents
D. Water for flushing
E. 60m1 syringe
F. pH indicator paper in a container
2. Wash and dry hands.
3. Prepare the formula feed as recommended:
Pour required amount of feed into a measuring jug. Keep the balance in the fridge.
B. FEEDING STEPS
1. Raise the patient to a sitting position or at least 45 degrees.
2. Check that the tube is in the stomach by using the following method:

Kink the feeding tube and connect the tip of a syringe into the feeding tube. Gently
draw back the plunger to withdraw the stomach contents.Dip a pH indicator paper into
the stomach contents if any. It should range from 1 to 6.

If there is no stomach contents, do the following:

Check the mouth, ensure no coiling of tube

Dip the tube into a cup of water: there should not be a continuous bubbling.

Dip the tube into a cup of water

DO NOT FEED if bubbles are present. Seek professional help.
3. Check for undigested feeds from the previous feeding by withdrawing all the stomach
contents with a 60 ml syringe.

If the amount is less than 120m1s. return the stomach contents and start to feed the
balance amount.
Example: Feed to be given is 200m1
Stomach contents: 80 ml
Balance water:
120m1
Water flushes:
20 ml
Total
.
220m1 (total volume)
Note; Total volume should not more than 300 mls for each feed
If the amount is more then 120m1 return the stomach contents, omit feed and check again 2
hours later. 2 hours later:

Feed if the amount is reduced

Do not feed if the amount is still 120m1s, or more. Contact your health care professional.
4. Place the tip of the syringe into the feeding tube and hold it at the level of the patient's
head.
Hold it at the level of the patient's head
5. Pour the prescribed feed into the syringe and allow it to flow slowly.
6. Observe the patient's tolerance while feeding.

C. AFTER FEEDING
1. Flush the tube with 20m1 of water (unless recommended otherwise by the healthcare
professional).
2. Kink the tube and disconnect the syringe. Replace the feeding tube stopper.
3. Do not turn or lay patient flat for at least half an hour after the feeding.
4. Wash the feeding set with water. Remove excessive water and store the feeding
apparatus in a clean container.

5. Wash and dry your hands.

DO

Keep the mouth and nose clean.

Perform oral care 3 times a day.
Ensure that the apparatus is clean and dry before each use.
Wash and dry your hands before and after preparing the feeds.
Check for expiry date of the enteral feeds formula before use.
Clean the top of the can with a damp paper towel before opening.
Store the feeds in cool dry place.
Refrigerate balance feed immediately.

DO NOT:

Feed if patient coughs, chokes or has difficulty breathing.

Use force to unblock the tube

Mix medication with the formula feed.

Use microwave to warm the feed.

Withhold feeding and seek professional advice if you observe:

Breathlessnes
s
Restlessness

Nausea&Vomiting
Diarrhoea

Bloated stomach

Aspirate more than 120m1s on

2 consecutive times