NASOGASTRIC TUBE

Nasogastric intubation is a medical

process involving the insertion of a plastic
tube (nasogastric tube, NG tube)
through the nose, past the throat, and
down into the stomach.

NASOGASTRIC TUBE

Indications
Diagnostic

Evaluation of upper gastrointestinal (GI)

bleed (ie, presence, volume)
Aspiration of gastric fluid content
Identification of the esophagus and
stomach on a chest radiograph
Administration of radiographic contrast
to the GI tract

Indications

Therapeutic
Gastric decompression, including maintenance of
a decompressed state after
endotracheal intubation, often via the
oropharynx
Relief of symptoms and bowel rest in the setting
of small-bowel obstruction
Aspiration of gastric content from recent
ingestion of toxic material
Administration of medication
Feeding
Bowel irrigation

Contraindications
Absolute

contraindications

Severe midface trauma

Recent nasal surgery
Relative

contraindications

Coagulation abnormality
Esophageal varices or stricture
Recent banding or cautery of
esophageal varices
Alkaline ingestion

EQUIPMENTS

TYPES OF NASOGASTRIC
TUBES
The Levin Tube -is a one-lumen nasogastric
tube

TYPES OF NASOGASTRIC
TUBES
The Salem-Sump Tube.
This tube is a two-lumen
piece of equipment.
It has a drainage lumen and
a smaller secondary tube
that is open to the
atmosphere.

TYPES OF NASOGASTRIC
TUBES
The Miller-Abbott Tube.
This tube is also a two-lumen
nasogastric tube.
There is a rubber balloon at
the tip of one tube; the
other tube has holes near
its tip.

TYPES OF NASOGASTRIC
TUBES
The Cantor Tube - has one lumen and a bag
on the end.

Infection Control
Hand

Washing
Wear a set of gloves
Wearing face and eye protection
Wear disposable apron.

IMPLEMENTATION
Verify

for physician order.

Identify Client & Introduce yourself
Explain the procedure
Assemble the Materials needed

IMPLEMENTATION
Explain the procedure, benefits, risks,
complications, and alternatives to
the
patient
or
the
patient's
representative.
Examine the patients nostril for septal
deviation. To determine which nostril
is more patent, ask the patient to
occlude each nostril and breathe
through the other.

OUR RESPONSIBILITY
Inserting

and removing the tube

Assessing correct placement
Securing the tube
Meeting patient comfort needs
Monitoring patient responses

POSITION
Position the patient in a High Fowlers
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.

CHECKING FOR PLACEMENT

Aspiration

of fluid from the tube,

with pH testing of the aspirate.
pH < 5 GIT
pH > 6 - Respiratory

CHECKING FOR PLACEMENT

Chest

X-ray

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, a collapsed lung, or
intracranial placement of the tube.

INTRACRANIAL PLACEMENT OF
THE TUBE
Inadvertent

Intracranial Placement of
a Nasogastric Tube in a Patient With
Severe Craniofacial Trauma

INTRACRANIAL PLACEMENT OF THE TUBE

INTRACRANIAL PLACEMENT OF THE TUBE

INTRACRANIAL PLACEMENT OF THE TUBE

INTRACRANIAL PLACEMENT OF THE TUBE