INSTALLATION NASO GASTRIC TUBE (NGT)

I. DEFINITION
Put a hose from the nose to the stomach that aims to provide enteral nutrition.

II. OUTCOME
As a therapy to provide nutrition / medicine directly to the stomach in patients
who are unable to meet nutritional needs orally.

III. INDICATION
1. Decompress gastric contents
Secreting gastric fluid in patients with obstructive ileus / paralytic peritonitis
and acute pancreatitis. Upper gastrointestinal bleeding to rinse the stomach
(secretes stomach fluid).
2. Enter Liquid/Food ( Feeding, Lavage Lambung)
The patient cannot swallow due to various causes of gastric lavage in
poisoning cases.
3. Diagnostic
Helps diagnose with gastric fluid analysis.

IV.CONTRAINDICATION
1. Patients with maxillofacial injury or anterior cranii base fracture
Nasal insertion of NGT has the potential for misplacement of NGT through
the cribiform fossa, causing intracranial penetration.
2. Patients with a history of esophageal stricture and esophageal varices.
3. Patients with esophageal tumors.

V. STANDAR OPERATINAL PROCEDURE

Critical Score
No. Procedure Point 0 1 2 3
1 Equipments Preparation
1.1 NGT hose (adjustable size)
1.2 Jelly for lubrication
1.3 Tongue spatel
1.4 Flashlight
1.5 Spuit 50cc
1.6 Plaster (prepare 5cm and 8cm
which has been cleaved)
1.7 Wipes
1.8 Mineral water
1.9 Sterile gloves
1.10 Stethoscope
2 Pre-interaction
2.1 Order verification
3 Orientation
3.1 Give greetings
(Assalamu’alaikum, introduce
yourself, call the name you like,
ask for age, address
3.2 Contract time of procedure
3.3 Explain the purpose of the
procedure
3.4 Give the patient a chance to ask
 Critical Score
No. Procedure Point 0 1 2 3
questions
3.5 Ask for patient / family
approval
3.6 Prepare the environment by
maintaining patient privacy
3.7 Bringing the instrument close to
the patient
4 Main Activity
4.1 Read Basmallah
4.2 *Wash hands with 6 steps
4.3 Assess the patient& level of
awareness and ability to follow
orders
4.4 Prepare equipment close to the
nurse, assess the patient& nose
condition clean from nasal
discharge
4.5 Ask the patient to relax and
breathe normally, assess the
patency of the breath and
determine the nostril to insert an
NGT tube (nose with lower air
flow)
4.6 Wash hands, wear gloves and
measure the length of the NGT
tube to be included:

Traditional method: measure

the length of the NGT tube from
the tip of the nose to the tip of
the ear to the xipoid proxesus

Hanson Method: first put a

mark on the size of 50cm then
do measurements like a
traditional measurement, the
length of the inserted hose is
between the mark of 50cm and
the results of the traditional
measurement
4.7 Put a mark on the measurement
results using prepared plaster
4.8 Give jelly to the 7-10cm NGT
interval
4.9 Tell the patient that the hose
will be inserted, ins let the
patient breathe normally. Try
the neck of the patient extension
4.10 Insert the tube slowly,
continue to enter until the
nasopharynx and then flex the
patient neck. Instruct sand to
swallow (give drinking
mineral water). Enter the NGT
interval to the specified limit.
If the patient coughs / chokes
for a short rest do not force to
continue inserting the hose
4.11 Check the position of the hose:
 Critical Score
No. Procedure Point 0 1 2 3
a. Insert the tip of the NGT hose in a
glass filled with water, if there are air
bubbles then the NGT gets into the
trachea incorrectly

b. Connect the air filled syringe to the

end of the NGT hose, place the
stethoscope on the hull and then enter
the air from the syringe. auscultate the
sounds that enter the stomach

c. Slow aspiration of gastric fluid

 4.12 If the hose is incorrectly

positioned on the stomach, insert
another 2-5 cm interval and double
check its position.

4.13 Fix the tube with tape, place the

end of the tape over the patient's nose

4.14 Clean the equipment, take off the

gloves and trim the patient

4.15 Wash your hands in six steps

5 Termination
5.1 Evaluate the patient's response to
the installation of NGT (Subjective and
Objective)

5.2 Observe for signs and symptoms of

side effects in the patient

5.3 Conclude the activity

5.4 Short Penkes

5.5 Next time contracts

5.6 Saying Hamdallah and praying for

the patient's recovery by saying
Syafakallah / Syafakillah

6 Documentation
6.1 Record patient response after NGT
installation

6.2 Record the date and time of the

NGT installation

7 Attitude
7.1 Politeness
7.2 Thoroughness
7.3 Safety
7.4 Emphaty
8 Total Score

9 Global Rating
 Critical Score
No. Procedure Point 0 1 2 3
Fail
Borderline
Pass
Excelent

VI.REFERENCE
1. Modul Keperawatan Medikal Bedah II