Nasogastric Tube

CREATED BY MR. JIHAD HASSAN

Indications:
 Enteral Feeding

 Administration of medication

 Aspiration of gastric fluid & content

 Bowel irrigation

 Gastric Lavage

 Assessment & treatment of Gastro-Intestinal bleeding

Equipment's:
Nasogastric tube

 Towel

 Disposable gloves

 Lubricant K- Y gel

 Gastric Bag

 Plaster
NGT insertion checklist:
1. Assess the patient's need for nasogastric tube insertion.
2. Wash hands and wear gloves.
3. Place the patient in high fowler's position (sitting) with the head tilted forward.
4. Stand on the right side of the bed.
5. Drape a towel around the patient's chest and shoulders.
6. Check the patency of the nares by check the air motion of the nostril while
the other is closed.
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7. Estimate the length of tube to be inserted by measuring the distance from the tip
of the nose to the earlobe and then to the 3-5 cm below xiphoid process and
mark this length with tape or ink.
8. Lubricate 6-10 cm of distal end of the tube by K Y gel.
9. Insert the tube into the selected nostril
10. Position curved edge of the tube downward and direct the tube along the base of
nostril.
11. Instruct the patient to swallow during insertion (if conscious).
12. Remove the tube immediately if resistance is found or there are signs of distress
or cough
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13. If no resistance, continue to pass the tube until marked position is at the rim of
the nostril.
14. Check the placement of tube through:
a-Connect 50 ml syringe to the tube and aspirate gastric content.
b- Inject 15-20 cc of air into the tube while auscultate with a stethoscope
over gastric bulb.
15. Secure the tube.
16. Remove gloves and wash hands.
17. Documentation (date, time, size of inserted tube and patient's response)
Contraindications:
 Basal skull fracture/ Head Trauma (oral)

 Recent Nasal Surgery

 Ulcers/ Varices

 Patient on anticoagulant therapy

 Any surgery in the digestive system

Special Cases
 If agitated patient, we can use oro-pharyngeal airway to hold the tongue

 Use Nebulizer with 3-5 cm xylocaine which will do anesthesia or the tongue

 If pediatric patient, size from nose to earlobe until xiphoidal-process

 If adult patient, between xiphoidal till umbilicus

Video showing the way for insertion of
NGT

https://youtu.be/WZvIw0SnYrE