NASOGASTRIC TUBE

( NGT )
INSERTION

MARYLENE D. LONTOC, RN, MAN

OBJECTIVES:

1. Familiarize with Nasogastric tube Indications, Purposes,

and Precautions.
2. Know the types of NGT.
3. Be competent in the demonstration of NGT Insertion.
NASOGASTRIC TUBE

NGT

- is a type of medical catheter that’s inserted through the

nose, past the throat, down the stomach. It’s used for limited
periods to deliver substances such as food or medications to
your stomach or to draw substances out.
NASOGASTRIC TUBE
NGT INSERTION

•refers to the process of placing a soft plastic

•nasogastric (NG) tube through a patient's nostril, pass the
pharynx and down the esophagus into a patient's stomach.
NASOGASTRIC TUBE
PURPOSE:
•to deliver tube feedings to a patient when they are unable
to eat.

•INDICATIONS: Patients who may need a NG tube for

feedings include: premature babies, patients in a coma,
patients who have had neck or facial surgery or patients
on mechanical ventilation.
NASOGASTRIC TUBE
CONDITIONS THAT MAY REQUIRE TEMPORARY NGT
INSERTION
For Enteral Nutrition
• Dysphagia
• Head and neck cancers
• Altered mental status
• Malnutrition
• IBD (inflammatory bowel disease)
• Endotracheal intubation
NASOGASTRIC TUBE
PURPOSE:
•To remove substances from the stomach.

•INDICATIONS: A NGT is used to empty the stomach when

accidental poisoning or drug overdose has occurred.
•A NG tube is used to remove air that accumulates in the
stomach during cardiopulmonary resuscitation (CPR).
NASOGASTRIC TUBE
CONDITIONS THAT MAY REQUIRE TEMPORARY NGT
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For Gastric Suctioning
• Toxic ingestion (poisoning)
• Gastroparesis (gastric outlet obstruction)
• Small bowel obstruction
• Intractable nausea and vomiting
• UGIB (upper gastrointestinal bleeding)
• GI injury
NASOGASTRIC TUBE
PRECAUTIONS

1. Do not use force when inserting a NG tube. If resistance

occurs, rotate and retract the tube slightly and try again.
Forcing the tube can cause traumatic injury to the tissue of
the nose, throat or esophagus.
NASOGASTRIC TUBE

PRECAUTIONS

2. Always check the tube positioning before giving feedings.

If the tube is out of place the patient may aspirate the
feeding solution into the lungs.
NASOGASTRIC TUBE

PRECAUTIONS

3. Keep the patient in an upright or semi-upright sitting

position when delivering a tube feeding to enhance
peristalsis and avoid regurgitation of the feeding.
NASOGASTRIC TUBE
PRECAUTIONS

4. Check patients who are receiving continuous feedings via

a pump or gravity hourly or according to the medical
settings policy, to assure that the tube is in position, the
formula is flowing at the correct rate and the patient is
comfortable with no signs of distention or distress.
NASOGASTRIC TUBE
PRECAUTIONS

5. Cap or clamp off the NG tube when not in use to prevent

backflow of stomach contents or accumulation of air in the
stomach.

6. If a patient has severe sinus conditions, nasal obstruction or

has had facial surgery, it may be necessary to place an oral-
gastric tube to avoid further nasal trauma
TYPES OF NASOGASTRIC TUBE
LEVIN TUBE
- single lumen
- holes near the tip
- prevents accumulation of intestinal
liquids and gas during and following
surgery. Prevents nausea, vomiting, and
distention due to reduced peristaltic action.
TYPES OF NASOGASTRIC TUBE
SUMP (SALEM)
- double lumen, radiopaque
- 1st lumen: suctioning of gastric contents
- 2nd lumen: blue extension (pig tail) open to
room air to maintain continuous flow of
atmospheric air into the stomach
- controls the amount of suction pressure placed
on stomach walls. Prevents injury, ulcers
NASOGASTRIC TUBE INSERTION
• NG tube
• Gloves
• Adhesive tape
• Asepto syringe
• Lubricant
• Stethoscope
• Facial tissue
• Safety pin
NURSING SKILLS
NURSING SKILLS
NURSING SKILLS
 NASOGASTRIC TUBE INSERTION
HOW TO CHECK THE NGT PLACEMENT
• Chest X-ray – the most accurate way
but not practical on a regular basis
• Aspirate pH test – the next best way
to check; lower pH of gastric content
• Syringe test – “whoosh test”; instill
30cc air bolus
THANK YOU!