Gastric Decompression Through a Nasogastric Tube

Overview

• Purpose: Removal of excess contents from the patient's stomach via a nasogastric tube (NG tube).
• Tools Needed:
  • Suction setup
  • Canister and suction tubing
  • Absorbent pad
  • Clean piston syringe
  • Gloves, hand hygiene

Preparation

• Patient Positioning:
  • Supine position
  • Head of bed (HOB) at least 30 degrees, ideally 90 degrees if tolerated
• Protective Measures:
  • Use absorbent pad over the chest to protect patient's gown and linens

Procedure Steps

1. Check Suction Device:
   • Ensure correct pressure setting (usually low intermittent suction)
   • Device typically found in patient's room on the wall
2. Check Tube Insertion Length:
   • Measure against patient size; usually marked by nurses near the nare
3. Confirm Tube Placement:
   • Aspirate gastric contents with piston syringe
   • Ensure tube is in the stomach by checking aspirated contents

Suction Process

• Unclamp Tube:
  • Ensure NG tube is not clamped to prevent leakage
• Attach Syringe:
  • Use syringe to aspirate contents
• Return Contents:
  • Push aspirated contents back to maintain stomach environment (bacteria, pH, electrolytes)
• Flush Tube:
  • Use 15 ml of room temperature water
• Connect to Suction:
  • Hook tube to suction tubing and then to suction canister
  • Recheck suction pressure
  • Monitor gastric contents flow and collect in canister

Monitoring & Measurement

• Track Output:
  • Measure and record gastric contents volume
• Patient Tolerance:
  • Assess patient's response to suction

Special Considerations

• Electrolyte Monitoring:
  • Loss of gastric contents can lead to electrolyte imbalance
• Suction Type:
  • Low intermittent suction preferred for gentleness
• Medications and Clogging:
  • Be cautious of administering meds down the tube
  • Flush tube to prevent and clear clogs