1 BY Al-hanouf AlKhayat Nasogastric Tube Insertion and Removal

2 Outlines: What is NGT?. Indication. Contraindications. NGT insertion procedure. Documentation. Complication. Removal of NGT.

3 Objectives: At the end of this lab the student will be able to: 1. Know the definition of NGT 2. Identify the indication and contraindication of NGT 3. Discuss Nursing and patient consideration of NGT 4. Monitoring the potential complication of NGT 5. Practice the insertion of NGT

4 What is NG Tubes? is a medical process involving the insertion of a plastic tube (nasogastric tube or NG tube) through the nose, past the throat, and down into the stomach.

5

6

7 Indication for NGT: For Feeding or to administer Medication. Decompression of gastric content after surgery. Irrigation To document presence of blood or to monitor it. To obtain a gastric Specimens for peptic ulcer Diagnosis.

8 Contraindication Absolute contraindications Severe midface trauma Recent nasal surgery Relative contraindications Coagulation abnormality Esophageal varices or stricture Recent banding or cautery of esophageal varices Alkaline ingestion

9 NGT Procedure:

10 1)Assessment: Assess the client conscious level. Check the patient chart for any previous History or nostril surgery. Use penlight to assess the nostrils for deviated septum. Ask the client to breath through each nostril occluding the other with finger. Assess for Latex allergy.

11 2)Equipment Needed: NGT Lubricant Syringe with catheter Tip,50 cc. Glass of water with straw. Towel Kidney basin. Tounge depressor Stethoscope Disposable gloves Hypo allergic tape or opsite.

12 Type of NGT: The Levin Tube

13 Type of NGT: The Salem-Sump Tube

14 Optional Equipment: Feeding pump

15 Optional Equipment: Disposable irrigation set.

16 Optional Equipment: Suction Equipments

17 3)Prepare the environment: Provide privacy. Positioning (Hi gh fowlers position). Cover the chest with towel.

18 4) Wash Hands and put on gloves

19 5)Measuring the distance for NGT Adult Measure from the tip of the nose, around the ear, and down to the xyphoid process.

20 Cont. Measurements: Infant Measure from the tip of the nose, around the ear and down to the umbilicus.

21 6)Lubricate the Tube Lubricate first 4 inches of the NGT.

22 7)Insertion Flex the the neck Backward. Insert gently into the nostril. Ask the client to tip Head forward. Advance the tube as the client swallow water. Withdraw if there is resistant or signs of respiratory distress.

23 Cont. insertion: Secure the NGT: by placing tape around the NGT and tape to cheek as well if desired. by placing tape around the NGT and tape to cheek as well if desired.

24 7)Check for placement of the tube: BY auscultation Aspirate for gastric content Chest X ray

25 Chest X ray

26 8) Remove gloves and wash Hand

27 9)Document the procedure: Date and time of procedure Indication for insertion Type of tube used Distance tube inserted (if appropriate) The nature of the aspirate Methods used to check location of the tube insertion Any procedural comments

28 Complications: Minor complications: Nose Bleeds,Sinusitis, and sore throat More significant complications: Erosion of the nose where the tube is anchored, esophageal perforation, pulmonary aspiration, a collapsed lung, or intracranial placement of the tube.

29 Removal of the NGT

30 References: Altman,G.2004.Delmar’s Fundamental and Advance Nursing Skills.Second Edition.Clifton Park:Delmar Learning.