NGT Insertion 2003

8/8/2019 NGT Insertion 2003

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NGT inserted through nostril passing the

nasopharynx until the stomach.


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1. ADMINISTER TUBE FEEDINGS &

MEDICATIONS in clients unable to eat by

mouth or at risk of aspiration GAVAGE gastric feeding

2. means of GASTRIC DECOMPRESSION To prevent gastric distention, nausea and

vomiting


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3. Diagnostic purposes for gastric content

analysis

Introduction of radiographic contrast for GIT

4. To wash off the stomach of poisons or

overdose in medications. LAVAGE gastric irrigation


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Severe midface injury

Recent nasal surgery

Coagulation abnormality Esophageal varices


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Large or small bore tube

Guidewire or stylet

Solution basin with ice or warm water Hypoallergenic adhesive tape

Clean gloves

Water soluble lubricant

Facial tissues

Glass of water with straw

20-50 ml syringe with an adapter


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Basin pH strip or Meter

Stethoscope Disposable Pad/Towel Clamp/Plug (Optional) Suction Apparatus

Gauze Square/Plastic Specimen Bag/Elastic band Safety Pin Feeding tube


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1. Assist to assume a High Fowlers position,

with head supported on pillow if condition

permits 2. Explain procedure.

3. Handwashing; observe universal blood andbody fluid precaution

4. Provide privacy. Place disposablepad/towel across chest.


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5. Assess clients nostrils.

Hyperextend the head, with the use of a flashlight

assess for tissue integrity of nares noting anyabrasions or irritations.

Check for obstructions or deformities by askingclient to breathe on one nostril at a time.

Select nostril with greater airflow.


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6. Prepare the tube

place tube on ice for 5-10 min if rubber

Warm water for plastic tube until it becomessofter/flexible.

Use a stylet secured in position for small bore.


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7. Determine how far to insert the tube.

Measure from the tip of the clients nose to th etip

of the earlobe to the tip of xiphoid process. Mark with tape if with no markings.


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8. Insert the tube Don gloves

Lubricate tip Insert tube with its natural curve toward client in

hyperextension of the neck, gently advance towardnasopharynx.

Direct tube along floor of nostril, toward ear onthat side

Apply slight pressure in nasopharynx, tearing ofeyes may occur. Offer tissues prn.


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8. Insert the tube Withdraw tube if with resistance, relubricate and

reinsert in the other nostril. Once it reaches the oropharynx, gagging may

happen.

Ask client to tilt head forward and encourage to

drink and swallow. IF gagging is encountered, stop passing the tube

momentarily, have client rest take a few breathsand sips of water.


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8. Insert the tube]

Pass the tube 5-10 cm(2-4 in) with each swallow.

If gagging persists and the tube does not advance,withdraw it slightly, inspect the throat if tube iscoiled in mouth. Withdraw and reinsert again.


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9. Check for correct placement.

Aspirate stomach contents, check for pH.

Auscultate air insufflation Place stethoscope over epigastrium after injecting

10-30ml air listen for whooshing sound

If placement is negative in the stomach, advancetube 5cm, repeat test.

If small bore is used, leave stylet in place untilposition is verified in Xray


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10. Secure the tube by taping it to the bridge

of the nose.

Wipe skin with alcohol Cut 7.5 cm (3in), split it lengthwise at one end

leaving a 2.5 cm tab at the end

Place tape over the bridge of the nose, bring splitends under or around the tubing and back up overthe nose


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11. Attach tube to suction or feeding

apparatus, or clamp the end of tubing.

It may be covered with a gauze or plasticspecimen bag and an elastic band.

12. Secure the tube to clients gown with an elasticband and a safety pin. Or adhesive tape to the

tube.


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1. Inspect nostril for discharge and irritation.

2. Clean nostril and tube with moistened

cotton-tipped applicators. 3. Apply water soluble lubricant if appears

dry.

4. Change adhesive tape prn.

5. Frequent mouth care.


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Irrigate with 30ml normal saline at regular

intervals, irrigations require order from

doctor. Document clients input & output, as well as

amount and characteristic of drainage.

Note clients comfort and tolerance to

procedure.

Chart date, time of insertion, means by which

placement was checked and clients response.


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NGT Insertion 2003

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