Nasogastric Tube Insertion

NASOGASTRIC TUBE INSERTION 3.
Be alert to the risk of tracheobronchial

aspiration, nasal erosion, esophagitis and
• To provide information about NGT gastric ulcers.
insertion, including the purpose of the 4. Carefully monitor patients with NGT and
procedure, potential complication and the with altered level of consciousness and
steps involved in performing the are unable to protect their airway.
procedure, information for patient and/or
family education. MATERIALS NEEDED:
• Nasogastric tube, Asepto syringe,

OBJECTIVES: lubricating jelly, gloves, tape ,cup of
water with straw, stethoscope, lidocaine
• After reviewing this information, the spray, personal protective equipment.
students should be able to:
• 1. State the uses for an NGT PRE-PROCEDURE STEPS:
• 2. Discuss patient conditions that must be
met in order for an NGT to be inserted. 1. Review facility /unit protocol for
• 3. Identify complications of improper inserting an NGT
NGT placement. 2. Review the doctors order.
• 4. Describe the procedure for inserting an 3. Review the patients medical
NGT in the adult patient. history/medical record.
4. Advised the patient that he/she may feel
DEFINITION: discomfort.
5. Explain that he /she will be given a cup of
• it is a flexible tube that provides access to water to sip or chips once the tube reaches
the stomach through the nose. the pharynx
• Commonly used types of NGT are the 6. Ask the patient to identify a signal that
• Levin tube and Salem sump tube he/she will use to communicate with you.
7. Perform laboratory testing to monitor cbc,
pt and ptt
PURPOSE: PROCEDURE STEPS:
1. To decompress the stomach by removing 1. Assess the patients to determine if the
fluids or gas to promote abdominal patient meets criteria for NGT placement.
comfort. 2. Assess mental status.
2. To allow surgical anastomoses to heal 3. Assess the patient’s nares.
without distention. 4. Use a penlight to inspect for anatomical
3. To decrease the risk of aspiration. abnormalities.
4. To administer medications to clients. 5. Ask the patient to breathe through his/her
5. To provide nutrition. nose and occlude one nostril at a time
6. To irrigate the stomach and remove toxic 6. Select the larger nares to ease insertion
substances. 7. Examine each nostril in order to
determine the most patent opening and
RED FLAGS: check for lesions or obstruction.
8. Check the condition of the NGT for defects
1. Limit insertion of an NGT from patients
such as rough edges.
recovering from gastric, nasal or
9. 9Stand on patient’s right side if you are right
craniofacial surgery.
handed, on left side if you are left handed
2. Do not instill any liquids through NGT or
because you will you your dominant hand.
connect it to suction until its placement its
10. obtain the patients verbal consent prior to
placement in the stomach has been
beginning of procedure.
confirmed.
11. Position and drape the patient for privacy NURSING CONSIDERATIONS:
12. The patient should be placed in a High-
Fowlers position with pillows behind the 1. NGTs may be inserted for variety of
shoulders. therapeutic or diagnostics purposes.
13. .Determine which nostril is more patent. 2. Prior to placing an NGT,assess the
14. Measure the length of the tube from the patient to determine if he or she meets the
bridge of nose to the earlobe to the xiphoid criteria of placement.
process and indicate with a piece of tape on 3. Complications associated with the use of
the tube an NGT can range from minor(such as
15. If the client is conscious and alert,have him nasal irritation,epistaxis and sinusitis) to
or her swallow or drink water. more severe.
16. .Lubricate the tip of the tube with water 4. NGT insertion is usually a BLIND
soluble lubricant. procedure using clean,not sterile
17. .Gently insert the tube into the nasopharynx technique.
and advance the tube.
18. when the tube nears the back of the throat,
instruct the patient to swallow or drink sips
of water(unless contraindicated).If resistance
is met, then slowly rotate and aim the tube
downward and toward the closer ear; In the
intubated or semi-conscious client, flex the
head toward the chest while passing the
tube.
PATIENT AND FAMILY EDUCATION:
1. Inform the patient that the presence of an

NGT can be mildly uncomfortable but
should not be painful or cause breathing
difficulties, coughing, choking ,vomiting
or skin breakdown. Alert the primary
clinician if these signs/symptoms occur.
2. Educate the patient to request assistance
when changing positions or getting
out of bed to avoid dislodging the tube.
USES OF NGT:
1. Administer fluids, medication and other

substances when oral administration is not
viable.(GAVAGE)
2. Remove stomach contents.(LAVAGE)
3. Decompress the stomach to prevent
aspiration of the stomach contents when
peristalsis is impaired.
4. Treat gastric or esophageal hemorrhage.
5. Provide diagnostics information, how to
evaluate for diaphragmatic rupture or
gastric contents for analysis.

Nasogastric Tube Insertion

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NASOGASTRIC TUBE INSERTION 3.

Be alert to the risk of tracheobronchial

• Nasogastric tube, Asepto syringe,

PATIENT AND FAMILY EDUCATION:

1. Inform the patient that the presence of an

1. Administer fluids, medication and other

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