Nasogastric Tube Removal Procedure

Overview

• Nasogastric tube removal is typically performed when enteral tube feeding is no longer necessary or the treatment is complete.

Required Supplies

• Stethoscope: To assess lung sounds
• Absorbent pad: To protect the patient's clothing
• Washcloth
• Piston syringe: For aspiration of gastric contents
• Gloves

Preparation

• Ensure the patient's head of the bed is elevated:
  • Preferably at 90 degrees, if tolerable
  • Minimum of 30 degrees
• Place an absorbent pad over the patient’s chest
• Discontinue any suction if applicable
• Perform hand hygiene and don gloves

Verification and Aspiration

• Verify NG tube placement by aspirating gastric residual:
  • Use a piston syringe to aspirate
  • Ensure gastric contents are replaced back into the stomach
  • Flush the tube with a small bolus of air to clear gastric contents from the line

NG Tube Removal Steps

1. Remove any securing device (e.g., nasogastric strip or tape)
   • Be cautious of skin breakdown from sticky securement strips
2. Clamp or fold the NG tube to prevent gastric backflow
3. Instruct the patient to hold their breath
4. Gently withdraw the tube while assisting the patient to lower their chin
5. Quickly withdraw the NG tube

Post-Removal Care

• Reassess the patient’s GI status
• Provide oral care to promote comfort
• Maintain the head of the bed at least 30 degrees for comfort and safety
• Remove absorbent pad and any used supplies
• Lower the bed to its lowest position for safety
• Perform hand hygiene
• Document the procedure

Additional Considerations

• Be mindful of potential skin breakdown around the nose due to securement strips
• Ensure comfortable positioning post-procedure
• Prioritize patient safety and hygiene throughout the process