Overview
This lecture covers nasogastric (NG) tubes, including their types, uses, insertion, placement confirmation, and removal procedures.
NG Tube Overview & Indications
- NG tube (nasogastric) passes from the nose to the stomach.
- Common uses: decompression (removing fluid/gas), medication administration, and enteral feeding.
Types of NG Tubes
- Double lumen (e.g., Salem Sump): large-bore, primarily for decompression and suction, can also give feeds/meds for short periods.
- Small-bore single lumen (e.g., Dobhoff): thinner, best for medication administration and feeding over longer periods.
Insertion Procedure Key Points
- Measure tube length using the NEX method: nose to earlobe, then earlobe to xiphoid process; mark length.
- Lubricate tube tip before insertion to reduce discomfort and injury.
- Encourage patient to swallow or sip water during advancement.
- Never force the tube past resistance.
- Check to ensure tube is not curling in the mouth.
Confirming Tube Placement
- Placement must be confirmed by x-ray before initial use.
- Do not use or connect to suction until x-ray confirms tube location.
- For future checks, aspirate gastric contents and verify pH (should be <5.5 if in stomach).
NG Tube Removal
- Flushing tube with water or air before removal is optional but helps clear tube.
- Instruct patient to take a deep breath and hold it during swift removal.
- Offer patient tissues and oral care after removal for comfort.
Key Terms & Definitions
- NG tube (Nasogastric tube) — tube inserted through nose into stomach for fluid removal, medication, or feeding.
- Double lumen (Salem Sump) — NG tube with two channels, mainly for suction/decompression.
- Small-bore single lumen (Dobhoff) — narrow tube for feeding/medications.
- NEX method — tube measurement: nose to earlobe to xiphoid process.
- Gastric pH check — using pH to confirm stomach placement (pH <5.5 expected).
Action Items / Next Steps
- Review facility/school policies for additional steps in NG tube procedures.
- Prepare for the next lecture on parenteral and enteral nutrition.