labskill NGT

7/28/2019 labskill NGT

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INDICATIONS

Use of a nasogastric tube is indicatedto:

Decompress the stomach by

aspiration of gastric contents (fluid, air,blood).

Introduce fluids (lavage fluid, tube

feedings, activated charcoal into thestomach.

Assist in the clinical diagnosis through

analysis of substances found in gastric


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An NG is normally put in so thatspecially prepared liquid food can be

put down the tube to feed your child.

The reason your child needs it forfeeding may include:

If your child has problems with their

sucking and swallowing


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If your child is not getting enoughnutrition through their normal diet

If your child cannot swallow the

medications they need Sometimes, an NG may be put in to

empty the stomach contents through

the tube.


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CONTRAINDICATIONS

Nasogastric tubes are contraindicated orused with extreme caution in people withparticular predispositions to injury fromtube placement. These may include:

Patients with sustained head trauma,maxillofacial injury, or anterior fossa skull

fracture. Inserting a NG tube blindlythrough the nose has potential ofpassing through the criboform plate, thuscausing intracranial penetration of the

brain.


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Patients with a history of esophageal

stricture, esophageal varices, alkali

ingestion at risk for esophageal

penetration.

Comatose patients have the potential ofvomiting during a NG insertion procedure,

thus require protection of the airway prior

to placing a NG tube.


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Caution should be utilized when passing a

NG tube in a patient with suspectedcervical spine injury.

Excessive manipulation or movement by

the patient during placement includingcoughing or gagging may potentiate

cervical injury.

Manual stabilization of the head isrequired during the procedure.


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EQUIPMENT REQUIRED

Non-allergenic tape

Protective pad or towel

Rubber Band

Gloves

Curved Basin


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Safety pin Cup of water with straw

Stethoscope

60 cc Irrigating syringe Water soluble lubricant

NG tube (plastic or rubber) of appropriate

size Suction


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PROCEDURE

If possible, explain the procedure to the

patient

Position the patient as follows: If the patient is awake and alert-in a sitting

position in high-Fowlers.

If the patient is obtunded or unconscious-head

down, preferably in a left side lying position.


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Place a protective pad/towel on the

patients chest as well as provide thepatient with a basin to minimize contact

with aspirated gastric contents.

Using the NG tube as a measuring devicedetermine the length of the NG tube to be

passed by measuring the length from

nose to earlobe

earlobe to xiphoid process


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Add the measurements together and mark

this total distance with a small piece of

tape.

Inspect both of the patients nostrils for

patency. Have the patient blow nose if

able.


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Lubricate the first 6 inches of the NGtube liberally with a water soluble

lubricant. Choose the largest patent

nostril and begin to pass the NG tubethrough the nostril to the nasopharynx;

direct the tube through the nostril

aiming down and back.


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Once in the pharynx instruct the patient to

swallow either mimicking the action or bysipping on small amounts of water. If

awake and alert have the patient place

chin to chest to facilitate easier passage of

the tube. Introduce the tube until the

selected mark (indicated by the tape) is

reached.


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Ask the patient to hum or

talk. Coughing, cyanosis or chokingmay indicate that the NG tube has

passed through the larynx.

Place the open end of the NG tubein a cup of water. Persistent

bubbling may indicate that the NG

tube has passed through the larynx.


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If unable to positively confirm that the NGtube has been placed is in the stomach

the tube must be removed immediatelyand re-attempted.

Once confirmed for placement, secure the

NG tube by placing one end of tape onfrom the bridge to the tip of the nose andthe other end wrapped around the tubeitself. If possible the nose should be clean

and prepped prior to securing with tinctureof benzoin.


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labskill NGT

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