Nasogastric Intubation

Present Ihsan ullah Wazir

 NASOGASTRIC TUBE

Nasogastric intubation is a medical process

involving the insertion of a plastic tube (nasogastric
tube, NG tube) through the nose, pass the throat, and
down into the stomach.
BRIEF HISTORY
 1790 that John Hunter
successfully fed a patient
via a flexible hollow
leather tube inserted into
the stomach(tube was
made of eel skin)
BRIEF HISTORY
 Nasogastric tubes were
used first in humans
for the purpose of
administering nutrition
 BRIEF HISTORY
 Theimprovement of acute care techniques
eventually led to improved patient survival
and many more people requiring nutritional
support, and this resulted in the practical
beginnings of modern enteral nutrition
NASOGASTRIC TUBE
 Indications
 Diagnostic
– Evaluation of upper gastrointestinal (GI)
bleed (presence, volume)
– Aspiration of gastric fluid content
 Indications
 Therapeutic
– Aspiration of gastric content from recent ingestion
of toxic material
– Administration of medication
– Feeding
 Contraindications
 Absolute contraindications
– Recent nasal surgery

 Relative contraindications
– Coagulation abnormality
– Esophageal varices or stricture
EQUIPMENTS
NASOGASTRIC TUBES
 SIZES
 Adult - 16-18F
Size FG-8 FG-10 FG-12 FG-14 FG-16 FG-18 FG-20
Colour Code Blue Black White Green Orange Red Yellow

 Pediatric - In pediatric patients, the correct

tube size varies with the patient’s age.
 Infection Control
 Hand Washing
 Wear a set of gloves
 Wear disposable apron.
 IMPLEMENTATION
 Verify for physician order.
 Identify Client & Introduce yourself

 Explain the procedure

 Assemble the Materials needed
 NURSING RESPONSIBILITY
 Insertingand removing the tube
 Assessing correct placement

 Securing the tube

 Meeting patient comfort needs
 Monitoring patient responses
 IMPLEMENTATION
Explain the procedure, benefits, risks,
complications, and alternatives to the patient
or the patient's representative.

Examine the patient’s nostril for septal deviation.

To determine which nostril is more patent, ask
the patient to occlude each nostril and breathe
through the other.
 POSITION
 Position the patient in a High Fowler’s position.
MEASUREMENT
Adult
– Measure from the tip
of the nose, around
the ear, and down to
the xyphoid process.
MEASUREMENT
Infant
– Measure from the tip
of the nose, around
the ear and down to
the umbilicus.
 INSERTION
 Lubricate the distal end of the Tube
 INSERTION
 Instruct the Patient to drink while the tube is
inserted
CHECKING FOR PLACEMENT
 Auscultation of air
insufflated through the
tube

 Immersion of the Proximal

end of in a glass of water.
 SECURE THE NG TUBE
 Anchor the tube securely to the nose and cheek -
keeping it out of the patients field of vision.
 COMPLICATIONS
 Minor complications
- Nose Bleeds, Sinusitis, and sore throat

 More significant complications

- Erosion of the nose where the tube is anchored,
esophageal perforation, pulmonary aspiration.
 DOCUMENTATION
 Date and time of procedure
 Indication for insertion

 Distance tube inserted (if appropriate)

 The nature of the aspirate

 Methods used to check location of the tube insertion

 Any procedural comments