NGT Procedure

Insert of Nasogastric Tube

Equipment:

- nasogastric tube( either Levin or Sump , size 12 to 18 French: most common size are 16 and 18 French).

- Irrigation syringe, 50 ml.

- Normal saline or water for irrigation.

- Water-soluble lubricant.

- Stethoscope.

- Suction apparatus ( if indicated).

- 1-inch addhesive tape.

- Emesis basin.

Procedure:

1. position patient in a semi-fowler’s position with head slightly flexed.

2. measure length of nasogastric tube ( NGT) to be inserted by placing tip of nasoastric tube at earlobe, then runnin the length of the nose, and then to xyphoid processuss. Mark this point with a piece of tape.

3. apply small amount of water-soluble lubricant to the tube.

4. insert nasogastric tube gently into nasopharynx. It should be inserted along medial floor of nose initially and then toward ipsilateral earlobe. The tube may need to be slightly rotated to move it from the nose to the pharyngeal area.

5. when the pharyngeal area is reached, encourage patient to swallow. Offer sips of water to the alert patient.

6. in the intubated patient, passage of the nasogastric tube may be facilitated by flexing the patient’s head to his chest.

7. insert the nasogastric tube until premeasured length is reached. Keep emesis basin handy in case patient vomits.

8. if respiratory distress is noted, withdraw the nasogastric tube immediately. This may indicated placement in trachea or bronchus.

9. verify placement of the tube in the stomach by aspirating gastric contents or by injecting 10 to 20 ml of air into tube while listening over stomach with stethoscope for rush of air.

10. tape the nasogastric tube in place with 1-inch adhesive tape using butterfly technique ( spiraling the wings down the tube).

11. attach to low suction ( 40 to 60 mmHg) if ordered by the physician. Sump tube require continous suction, and Levin tubes require intermitten suction.