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.
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Indications
Nutritional support
Bowel obstruction
Oral medications
Poisoning, overdose
Gastric analysis
Contraindications
Absolute Contraindications
Relative Contraindications
📋 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.