Nasogastric Tube

(NGT)

<Procedures>

<Index>

 

 

 

Definition

-  Insertion of tube into stomach via nasopharynx to gain access to contents

 

Features

-  Commonly performed by nurses on ward

 

Indications

-  Continuous vomiting, resting bowel post-op

-  Decompress

-  Distended abdo

-  Small bowel obstruction

-  Paralytic ileus

-  Feeds: stroke, comatose

-  Pump stomach: poisoning (Paracetamol OD..)

-  May be placed intra-op

-  Paeds

-  Gastroenteritis

-  Any case of dehydration w failed oral hydration

 

Contraindications

-  Oesophageal stricture

-  Comatose pt

-  Penetrating neck trauma, BOS fracture

 

Equipment

-  Dressing pack

-  Spiget

-  +/- litmus

-  Cup & water +/- straw

-  Gauze & bluey

-  Tubes: 8, 10, 12, 14 French

-  Lubricant: 2% Xylocaine jelly or KY

-  Anaesthetic spray

-  Syringe

 

Procedure

-  Patient at 45o (High Fowlers position)

-  Place bluey under chin

-  Measure tube length (nose, ear, xiphisternum)

-  Explain to patient put your hand up if you want me to stop

-  Examine nostrils for obstruction

-  Lube tube & insert into nose

-  For children can just use NS instead of lube

-  Insert posterior & inferior

-  Do not force tube

-  Do not insert superiorly

-  Once into oropharynx pt to swallow

-  Chin to chest

-  Drink water

-  If intra-op can use forceps to assist intubation

-  Insert to mark

-  Tape in position

-  Confirm location of tube

-  Aspirate stomach & use litmus paper: acidic

-  Inject air & auscultate stomach w stethoscope

-  CXR for placement

-  Must indicate for NGT placement on request

-  Should be inferior to diaphragm

-  Make sure not in bronchi

 

 

Complications

-  Aspiration --> aspiration pneumonia

-  Tissue trauma

-  Gagging, vomiting