NGT Insertion 2022

NGT INSERTION
&
GASTRIC GAVAGE
PREPARED BY:
MS. DOVE CHRISTIAN C. SUMAGANG, RN, MAN
NASOGASTRIC TUBE INSERTION
• Definition: The insertion of a

nasogastric tube (NGT) through
one of the nostrils, down the
nasopharynx and into the
stomach
Purposes:
• To provide a route for
feeding the client
• To prevent nausea, vomiting
and gastric distention
following surgery
• To remove stomach contents
for laboratory analysis
• To lavage the stomach in
cases of poisoning or
overdose of medications
TOTAL ENTERAL NUTRITION
• Enteral= through the gastrointestinal system

• Provided when the client is unable to ingest foods or the
upper GIT is impaired and the transport of food to the
small intestine is interrupted
• Enteral feedings are administered through NGT or small-
bore tubes or through gastrostomy or jejunostomy
NASOGASTRIC TUBE (NGT)
• A tube that is passed through the nose and down

to the nasopharynx and esophagus into the
stomach
• Flexible tube made of rubber or plastic
COMMON TYPES OF TUBES
• Nasogastric: through the nose into the stomach

• Percutaneous: Percutaneous Endoscopic Gastrostomy
(PEG): placed through the skin
• Endoscopic: placed with an instrument called an
endoscope
• Gastrostomy: inserted into the stomach
Percutaneous Endoscopic Gastrostomy
TYPES OF NASOGASTRIC TUBES
1.Levin Tube
• Single lumen with holes near
the tip
• Prevents accumulation of
intestinal liquids and gas during
and following surgery
• Prevents nausea, vomiting and
distention due to reduced
peristaltic action
2. Salem Sump
• Double lumen
• Radiopaque
• 1st lumen: suction of gastric
contents
• 2nd lumen: blue extension (pig tail)
open to room air to maintain a
continuous flow of atmospheric air
into the stomach
• Controls the amount of suction
pressure placed on stomach walls;
Prevents injury and ulcers
3. Moss Tube
• Tri-lumen
• 1st lumen: balloon anchors it
in the stomach (retention
balloon)
• 2nd lumen: feeding tube
• 3rd lumen: aspiration and
lavage
4. Miller – Abott Tube
• 2 lumens
• 1st lumen: rubber
balloon tip; should not
be inflated until it
passes through the
pylorus
• 2nd lumen: for
suctioning
4. Sengstaken- Blakemore
• Triple lumen
• 1st lumen: inflates the
balloon in the stomach to
press against the
esophagogastric junction
• 2nd lumen: inflates the
balloon in the esophagus
to press directly against
varices
• 3rd lumen: used for
aspiration and lavage
Measuring the Length of the Tube to be
Inserted
• The 1st measurement:

from the tip of the
client’s nose to the
earlobe
• The 2nd measurement:
from the earlobe to the
xiphoid process.
Checking for Tube Placement
1. Aspirate stomach contents

• Stomach aspirate will appear cloudy,
green, tan, off-white, bloody, or brown
2. Check pH of aspirate
• considered more accurate
than visual inspection.
• Stomach aspirate: pH range
of 0 to 4, commonly less than
4
• Aspirate of respiratory
contents: generally more
alkaline, with a pH of 7 or
more.
3. Inject 30 mL of air into
the stomach and listen
with the stethoscope for
the “whoosh” of air into
the stomach
4. Confirm by x-ray
placement
• X-ray visualization is
the only method that
is considered positive
Securing the NGT
GASTRIC GAVAGE (NGT FEEDING)
GASTRIC GAVAGE
DEFINITION:
Gastric Gavage is a means of
supplying nutritional substance
via a small plastic tube directly
to the stomach.
GASTRIC GAVAGE
PURPOSES:
• To provide feeding
• To administer medications
• To administer supplemental fluids
INDICATIONS:
• Gastrointestinal diseases and
surgery
• Hypermetabolic states (burns,
multiple trauma, sepsis, cancer)
• Certain neurologic disorders (stroke
and coma)
• Following certain types of surgery
(head and neck, esophagus)
EQUIPMENT:
• Osteorized Feeding (OF) formula
• Calibrated drinking glass
• Stethoscope
• Asepto syringe
• Water (for flushing)
• Clean gloves
NURSING CONSIDERATIONS
• Tube feedings should be at room temperature
- liquids not at room temperature can cause gastric cramping
and discomfort
• Shake feeding well
• Position client on Semi- Fowler’s position before and after
feeding
• Elevate feeding at least 18 inches away from insertion site during
feeding
•
• Check for NGT placement before each
feeding.
• When feeding, pinch the proximal end of the
feeding tube.
• When feeding, allow flow of feeding by
gravity.
• Tablets should be properly crushed during
preparation of meds to be administered.
• Medications should be given after OF is
administered. Never mix medications with
OF.
• Allow patient to remain in Semi-Fowler’s
position for at least 30 minutes after the
feeding.
DOCTOR’S ORDER
• Give OF 1500 ml via NGT in 6 equally divided
feedings with Strict Aspiration Precaution

NGT Insertion 2022

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NGT INSERTION

• Definition: The insertion of a

• Enteral= through the gastrointestinal system

• A tube that is passed through the nose and down

• Nasogastric: through the nose into the stomach

• The 1st measurement:

1. Aspirate stomach contents

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