Name: ______________________________________________ Date: ________________

Section: ______________________

NASO GASTRIC TUBE INSERTION AND REMOVAL

Basic Concept: A tube that is inserted through the nose, down the throat and esophagus, and
into the stomach. It can be used to give drugs, liquids, and liquid food, or used to remove
substances from the stomach. Giving food through a nasogastric tube is a type of enteral
nutrition. Also called gastric feeding tube and NG tube.
Objectives:
1. To remove section and Gaseous substances from the Gastro Intestinal Tract to prevent
abdominal distention
2. To instill nutritional supplement or feeding into the stomach for patient who are
unable to swallow fluids
3. To apply intestinal pressure by means of an inflated balloon to prevent internal
hemorrhage
4. To irrigate the stomach in case of active bleeding
5. To obtain specimen for gastric content for laboratory studies.

Equipment:
A. Salem Sump or Naso Gastric Tube
B. WATER proof pad or towel
C. Two inches hypoallergenic tape
D. Water soluble or KY jelly
E. Penlight
F. Glass of water
G. Straw
H. Emesis Basin
I. Asepto Syringe
J. Stethoscope
K. Rubber Band
L. Safety Pins
M. Connecting Tube
N. Suction Apparatus (Optional)
O. Normal Saline Solution
P. Gloves

Patient
 A. Explain the procedure to the patient. Tell the patient that he may feel discomfort in
his nose and that the procedure may cause him to gag or shed tears.
B. To facilitate easy insertion, have the patient practice panting, mouth breathing and
swallowing.
C. Establish a hand signals technique, the patient can use when he needs to rest during
the insertion.
D. Place in a high- fowlers position.
E. Place a towel or water proof pad in the chest,
F. Remove any dentures that do not fit well.

Implementation Rationale
1. Put on Gloves

2. Remove NGT from the packages

3. Measures the length of the NGT to be

inserted using the methods:

A. Measure distance by holding the

distal end of the tube to the tip of the
nose to the earlobe and xiphoid
process.

4. Place an adhesive tape/marker to

indicate total length you have measured.

5. Using the penlight examine the nostrils

for septal defect deviation.

6. Occlude one nostril and observe for

mechanical obstruction of the other
nostril. Assess the airflow

7. Curve end of the tube around fingers and

hold for a few seconds

8. Lubricate the first 2-3 inches of the tube

with a KY jelly never used a mineral oil

9. Have patient hold his head up straight.

Then carefully insert the tube into the
nostril with better flow
10. Aim the tube towards the ears and
downward angle position, gently passing
in the oropharynx

11. When the tube reaches the nasopharynx,

you will feel a resistance. Tell the patient
to lower his head slightly.

12. Rotate the tube about 10 degrees

towards the nostril

13. Put emesis Basin on the bedside or

infront of the patient

14. Hand the patient with a glass of water

with straw and tell the patient to
swallow as you slowly advance the tube

15. If the patient is in respiratory distress,

the tube maybe in the bronchus.
Withdraw the tube immediately.

16. Do not force the tube in faster than the

patient can swallow. Stop advancing the
tube when you reach the marked tape

17. Confirm Placement

A. Aspiration stomach contents with an

asepto syringe
B. Injecting 5-10 cc of air into the tube
as you auscultate for whoosing
sound over the epigastric region.
C. Submerging the distal end of the
tube in water
D. If the above measures do not
confirm proper placement request
for an X-ray.

18. Remove Gloves

19. Secure end of the tube with a tape or a
clip made for that purpose

20. To reduce discomfort from weight of the

tube, loop the rubber band around the
tube and attach it to the patient gown,
using a pin.

21. Pin the end of the tube above the

stomach

22. Attached the NGT to the connecting

tubing or clamp the tube.

23. Chart the procedure and reaction of the

patient.

NGT REMOVAL
a. Preparation
1. Verify the doctors order
2. Instruct the patient of the procedure

b. Equipment
1. Gloves
2. Clean Towel
3. Tissue
4. Asepto Syringe
5. Normal Saline

c. Patient
1. Assess for gastric drainage, bowel sound, flatus, nausea, vomiting and abdominal
distention
2. Explain the procedure
3. Position Semi- Fowlers
4. Place a clean towel chest area of the patient and offer tissues for the patient.

Implementation Rationale
1. Check for the placement of the tube

2. Flush the tube with 10ml of normal

saline solution
3. Clamp the tube securely by holding
and folding the tube

4. Have patient take a deep breath and

have him hold it slowly as you
remove the tube.

5. Place the removed tube in a plastic

or towel away from the patient

6. Do Mouth Care

7. Observe for the next 48 hours the

patient for: Nausea, Vomiting,
Abdominal Distention and Food
Intolerance

8. Chart the procedure