What is nasogastric tube insertion?

Answer 1

A nasogastric tube is a small plastic tube inserted through the nose and down the esophagus into the stomach. It either serves as a tube for feeding liquid nutrition to someone who cannot swallow or to suction the stomach contents following gastric surgery.
NG tube is used for decompression of a distented stomach by draining the fluid build-up out. The etiology of distention is bowl obstruction, intenstine blockage, and prolonged stay of food in stomach.

The term "gavage" is for entreal feeding and the term "lavage" is for irrigation of stomach for an over-dosed or poisoned pt. The more sophisticated ng tubes can manage feeding, suctioning, irrigating and medicating all through one closed port.

A Salem sum ng tube is most frequently used for and has an air vent (called a "pig tail") side tube. The air vent should never be closed off during drainage because it provides the pressure to aspirate. The only time the air vent is allowed to be closed off is when checking for proper ng tube placement by pushing15-20 mL of air into stomach and auscultate for the wooshing sound. If the air vent's open, air will not be delivered into the stomach.

NG insertion procedure:

1. Position pt. in high fowler's position for ease of tube insertion.

2. Ng tube length is the length from tip of nose to tip of ear to end of xiphoid process. This is called a traditional measurement. Alternative measurement is the midway between a 50-cm point on the tube and the traditional measurement.

Curve tube, lubricate 3-4 inches, remove denture.

3. Contradictions: pt. with facial, pharynx, or esophagus trama, "orogastric tube may be inserted." http://intermed.med.uottawa.ca/procedures/ng/

4. NG insertion pathway: (extend head back against pillow)nares, floor of nasal passage, (aiming toward opposite ear and rotate), nasopharynx, stop advancement for pt. to relax and advise the next step requires pt. to swallow a sip of water or ice chips, (now gently press pt's head down and flex head forward) oropharynx, past pharynx, then esophagus, and finally stomach.

5. Check tubing placement:

5a. Most accurate way is x-ray.

5b. When x-ray not accessbile, check gastric content with pH value 1-4 by using test strip. pH value 5.5 is respiratory secretions.

5c. Aspirate syringe to observe gastric color, which should be green.

5d. Auscultate on ULQ by inserting 15-20 mL of air into stomach, close off air vent of Salem sump (the only time you are allowed to do so) and listen for wooshing sound.

6. Once ng tube placement confirmed, anchor tube by tape on nose, cheek. Fasten tube on client's gown by looping rubber band around tube in slip knot. Pin rubber band to gown. Tube end is either clamped or connect to suction machine for most of the cases or drainage bag.

7. Bed position 30 degrees or greater.

8. Connec to gumco suction machine. Set it on intermittent or low pressure @ 80-100 mmHg. If flow's too slow, use 30 mL of normal saline to irrigate(see ng irrigation). Turn pt. to side to aspirate irrigant.

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Answer 2

Nasogastric-- Tube inserted through the nasal passages into the stomach.