Nasogastric Tube Insertion

GENERAL OBJECTIVE
After finishing skill practice of procedure for inserting Naso Gastric Tube, the student will be able
to perform procedure of inserting Naso Gastric Tube correctly.

SPECIFIC OBJECTIVE
At the end of skill practices, the student will be able to perform inserting Naso Gastric tube
correctly.

Syllabus Description :

a) Sub Module Objective

After finishing skill practice of aseptic techniques procedure, student will be able to
perform for inserting Naso Gastric Tube correctly.
b) Expected Competencies
Perform procedure for inserting Naso Gastric Tube correctly
c) Topics
• Indication and contraindication
• The principle of the procedure
a. Main step train the students to perform main pocedure of inserting Naso
Gastric tube correctly
b. Attributed step
i. Introduction: train the student to perform the informed concent and
collecting the patient data.
ii. Preparation: train the sudent to perform the aseptic/antiseptic
procedure and instrument checking. iii. Concept and rational
explanation of each step
iv. Expectation and risk of the procedure
v. Handling/management of the risk
d) Methods
• Presentation
• Demonstration
• Coaching
• Self practices
Attachment
1. Instrument, substances and material needed Presentation :
Audiovisual : Slides presentations on LCD projector.

Demonstration and coaching :

• Examination couch
• Stethoscope
• Nasenteric tube insertion model
• Naso Gastric tube
• Lubricant
• Syringe

• Hand gloves • Non allergic tape

2. Assessment:
Performance scale 0 = Neither mention nor do the procedure
Performance scale 1 = Only mention the procedure
Performance scale 2 = Mention and do the procedure

Learning Guide of Inserting Naso Gastric Tube

Performance
Scale
No. Procedure
1 2 3

Preparation

1. Check all the equipment required and have a good condition :

Nasoentric Tube; Hand gloves; Lubricant

2. Explain the procedure and its goals to the patient.

3. Wash your hands with antiseptic soap and dry your hands with tissues or
hand towel

Implementation

4. Provide privacy
5. Place patient in sitting position with neck flexed slightly and head of bed
elevated to 45 degrees

6. Inspect nares and determine optimal patency by having the patient

breathe through one nostril while the other is occluded temporarily

7. Use Hand gloves

8. Estimate distance for placement into stomach by measuring the length

from the tip of the nose to the earlobe and then from the earlobe to the
xiphoid process, add 5 cm to his length

9. Observe marking on shaft of tube for guidance (can use plaster or marker)

10. Lubricate the end of the tube with water based lubricant and pass it
posteriorly

11. If The patient is alert and cooperative, ask him or her to swallow water to
facilitate tube passage

12. Once the tube is beyond the nasopharynx (feeling any resistance when
andvancing the tube), allow the patient to rest

13. Have the patient flex the neck and swallow while the tube is advanced

14. If the patient begins to cough, withdraw the tube into the nasopharinx,
and then reattempt passage.

15. Confirm the passage into stomach by:

1. placing stetoscope over xyphoid processes and injecting 30 ml of
air (using 50 ml catheter tip).

2. aspirate gastric contents and check the acidity using lacmus paper
3. abdominal x-ray film.
16. Secure tube to bridge of nose or upper lip with nonallergic tape or tube
attachment device.

17. Cover the tube opening using plastic bag, or fold it and secure with
plaster.