Nasogastric Tube Insertion

Introduction

• Demonstration by Ellis from Level Up RN on how to insert a nasogastric (NG) tube.
• Utilizes steps from Clinical Nursing Skills cards.
• Importance of prepared environment and patient readiness.

Preparation

• Elevate head of the bed.
• Cover patient’s chest with a towel.
• Provide an emesis basin and tissues in case of gag reflex or vomiting.
• Prepare tape in advance for securing the tube.

Required Equipment

• Tape
• Lubricant
• Nasogastric tube
• pH strips
• Container
• Piston syringe

Measuring and Lubricating the Tube

• Measure the required length:
  • From the tip of the nose to the earlobe.
  • From the earlobe to the xiphoid process (tip of the sternum).
  • Mark estimated insertion length with tape or marker.
• Lubricate the tube before insertion.

Inserting the Tube

• Ask the patient to flex their neck.
• Insert tube into the nare; stop if encountering extreme resistance.
• Encourage patient to swallow to guide the tube into the esophagus.
• Secure the tube to the cheek at the marked length.

Confirming Placement

• Use a piston syringe to withdraw gastric secretions.
• Test secretions with pH strip; pH should be less than 5.
• An x-ray is the gold standard for confirming placement.

Securing and Using the Tube

• Anchor tube more securely to the nose using the split tape method.
• Can attach tube to patient’s gown for support.
• Connect to suction if ordered:
  • Attach to suction tubing and canister.
  • Adjust suction level as needed.

Removing the Tube

• Turn off suction before removal.
• Retest placement and flush tube as per facility policy.
• Remove securement and instruct patient to hold breath during removal.
• Mucus may be present; provide tissues and cleanup materials.

Important Notes on Tube and Ports

• NG tube has an adapter for connecting to suction tubing.
• Clamp the tube during insertion/removal to prevent gastric secretions.
• Blue port is an air vent: do not use for flushing or medication.
• All activities should be done through the main port.

Conclusion

• Proper steps and precautions ensure safe and effective use of a nasogastric tube.
• Emphasis on correct use of ports and securing methods.