Overview

Nasogastric Tube insertion is a procedure used to place a tube through the nose into the stomach for feeding, medication administration, or gastric decompression.

NG tube insertion is crucial for providing enteral nutrition, administering medications, and decompressing the stomach in various medical conditions.

Indications

Enteral Feeding

Nutritional support

Gastric Decompression

Bowel obstruction

Medication Administration

Oral medications

Gastric Lavage

Poisoning, overdose

Diagnostic Testing

Gastric analysis

Contraindications

Absolute Contraindications

Patient refusal
Nasal obstruction
Esophageal varices

Relative Contraindications

Recent nasal surgery
Coagulopathy
Severe facial trauma

📋 Equipment Checklist

Check off items as you gather them:

Pre-procedure Preparation

Preparation includes patient consent, equipment setup, and understanding contraindications.

Step-by-Step Procedure

Step 1: Patient Preparation

Explain procedure, obtain consent, position patient.

⚠️ Common Mistakes to Avoid:

  • Inadequate consent
  • Poor positioning

💡 Pro Tip:

Position patient upright.

Step 2: Tube Measurement

Measure tube length from nose to ear to xiphoid.

⚠️ Common Mistakes to Avoid:

  • Wrong measurement
  • Poor technique

💡 Pro Tip:

Use proper measurement technique.

Step 3: Tube Lubrication

Lubricate tube tip with water-soluble lubricant.

⚠️ Common Mistakes to Avoid:

  • Inadequate lubrication
  • Wrong lubricant

💡 Pro Tip:

Use generous lubrication.

Step 4: Tube Insertion

Insert tube through nostril with proper technique.

⚠️ Common Mistakes to Avoid:

  • Wrong angle
  • Force

💡 Pro Tip:

Use gentle technique.

Step 5: Placement Confirmation

Confirm tube placement with multiple methods.

⚠️ Common Mistakes to Avoid:

  • Inadequate confirmation
  • Wrong method

💡 Pro Tip:

Use X-ray for confirmation.

Step 6: Tube Securing

Secure tube properly to prevent dislodgement.

⚠️ Common Mistakes to Avoid:

  • Poor securing
  • Dislodgement

💡 Pro Tip:

Use proper taping technique.

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Post-procedure Care

Post-procedure care involves confirming placement, monitoring for complications, and tube maintenance.

Complications & Management

Complication Incidence Signs Management Prevention
Nasal trauma 5-10% Bleeding, pain Removal, nasal packing Gentle technique
Esophageal perforation 0.1-1% Chest pain, mediastinitis Surgery, antibiotics Gentle technique
Pulmonary placement 1-3% Cough, respiratory distress Removal, chest X-ray Proper confirmation
Sinusitis 2-5% Facial pain, purulent discharge Antibiotics, removal Proper technique

Clinical Pearls

💡

Measure tube length properly.

🎯

Use generous lubrication.

Confirm placement with X-ray.

🔍

Use gentle insertion technique.

📊

Secure tube properly.

🎨

Monitor for complications.

⚠️

Remove when no longer needed.