Overview
This lecture explains the step-by-step procedure for inserting a nasogastric (NG) tube, including preparation, insertion, verification, and securing the tube.
Preparation & Supplies
- Gather gloves, NG tube, tape, pH strips, lubricant, large syringe, and a cup with a straw.
- Wash hands, verify patient identity with two identifiers, and provide privacy.
- Optional: Soak NG tube in room-temperature water to soften it.
- Raise the bed to a comfortable height and position the patient in high Fowler’s (upright sitting).
Tube Measurement & Patient Positioning
- Choose the nostril on the same side as where you stand.
- Measure tube length from nose tip to ear, then to the xiphoid process (lower sternum).
- Mark the tube at the measured length using tape if not pre-marked.
Insertion Technique
- Lubricate the end of the tube for patient comfort.
- Use the tube’s natural curve to aid insertion, angling down toward the opposite ear.
- Insert tube a short distance, pause to check on the patient, then continue.
- Instruct the patient to sip and swallow water as you advance the tube.
Placement Verification
- Watch for signs of respiratory distress (coughing, choking, inability to speak), indicating possible misplacement in the trachea—remove tube if this occurs.
- Monitor patient with pulse oximetry during insertion.
- Attach syringe, withdraw gastric contents, and test with pH strip; a pH of 1–4 confirms stomach placement.
- Chest X-ray is commonly ordered to further verify placement.
Securing the Tube
- Use stat lock device if available, or tape:
- Split tape: stick part to nose, wrap rest around tubing to secure.
- Secure tube to the gown with a safety pin or additional tape to prevent accidental removal.
Key Terms & Definitions
- NG Tube (Nasogastric Tube) — a flexible tube inserted through the nose into the stomach for feeding or drainage.
- High Fowler’s Position — patient sitting upright at a 60–90° angle.
- Xiphoid Process — the lowest part of the sternum (breastbone).
- pH Strips — test strips that indicate the acidity of stomach contents.
Action Items / Next Steps
- Review tube insertion steps and practice measuring and taping techniques.
- Prepare for potential chest X-ray verification if required.
- Learn to recognize signs of incorrect tube placement.