NGT Villareal
NGT Villareal
Definition
- By inserting a nasogastric tube, you are gaining access to the stomach and its contents. This enables you to
drain gastric contents, decompress the stomach, obtain a specimen of the gastric contents, or introduce a
passage into the GI tract. This will allow you to treat gastric immobility, and bowel obstruction. It will also allow for
drainage and/or lavage in drug overdosage or poisoning. In trauma settings, NG tubes can be used to aid in the
prevention of vomiting and aspiration, as well as for assessment of GI bleeding. NG tubes can also be used for
enteral feeding initially.
Contraindications
Complications
The main complications of NG tube insertion include aspiration and tissue trauma.
Placement of the catheter can induce gagging or vomiting, therefore suction should always be ready to use
in the case of this happening.
Universal precautions/Principles:
The potential for contact with a patient's blood/body fluids while starting an NG is present and increases with
the inexperience of the operator.
Gloves must be worn while starting an NG; and if the risk of vomiting is high, the operator should consider
face and eye protection as well as a gown.
Trauma protocol calls for all team members to wear gloves, face and eye protection and gowns.
Equipment:
All necessary equipment should be prepared, assembled and available at the bedside prior to starting the NG
tube. Basic equipment includes:
NG/OG tube
Adhesive tape
Stethoscope
Emesis basin
pH indicator strips
PROCEDURE RATIONALE
3. Explain the procedure to the patient and show - To gain the patient’s trust and coordination.
equipment
- To reduce the patient’s anxiety.
4. If possible, sit patient upright for optimal -Full Fowler’s position assists the client to swallow, for
neck/stomach alignment optimal neck-stomach alignment and
promotes peristalsis.
5. Examine nostrils for deformity/obstructions to - If the client has difficulty breathing out of one nostril,
determine best side for insertion try to insert the NG tube in that one. The client may
breathe more comfortably if the “good” nostril remains
patent.The blocked nasal passage may not be totally
occluded and thus you may still be able to pass an NG
tube. It may be necessary to use the more patent
nostril for insertion.
6. Measure tubing from bridge of nose to earlobe, then - Mark this spot with a small piece of temporary tape or
to the point halfway between the end of the sternum note the distance. Each client will have a slightly
and the navel different terminal insertion point. Measurements must
be made for each individual’s anatomy.
7. Lubricate 2-4 inches of tube with lubricant - To help alleviate the discomfort.
(preferably 2% Xylocaine). This procedure is very
uncomfortable for many patients, so a squirt of
Xylocaine jelly in the nostril, and a spray of Xylocaine to
the back of the throat will help alleviate the discomfort.
8. Pass tube via either nare posteriorly, past the - Advance the tube until the correct marked position on
pharynx into the esophagus and the tube is reached.
then the stomach.
9. Withdraw tube immediately if changes occur in - To prevent further complication. Let the client rest a
patient's respiratory status, if moment and retry on the other side.
tube coils in mouth, if the patient begins to cough or
turns pretty colours
10. Advance tube until mark is reached - To check for placement before securing the tube. The
tube may move out of position if not secured before
checking for placement.
11. Check for placement by attaching syringe to free - Visual inspection is needed in this situation. Withdraw
end of the tube, aspirate sample of gastric contents. Do the entire tube and start again if such thing occurred.
not inject an air bolus, as the best practice is to test the
pH of the aspirated contents to ensure that the contents
are acidic. The pH should be below 6. Obtain an x-ray
to verify placement before instilling any
feedings/medications or if you have concerns about the
placement of the tube.
12. Secure tube with tape or commercially prepared - Securing the tube in place will prevent peristaltic
tube holder movement from advancing the tube or from the tube
unintentionally being pulled out.
13. If for suction, remove syringe from free end of tube; - To prevent further complication.
connect to suction; set machine on type of suction and
pressure as prescribed.
14. Document the reason for the tube insertion, type & - Documentation of relevant information and serves as
size of tube, the nature and amount of aspirate, the future reference for legal purposes.
type of suction and pressure setting if for suction, the
nature and amount of drainage, and the effectiveness
of the intervention.