University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

103

Pages:

2
Author:

Mariam A. A.

Insertion of Nasogastric Tube Indications Indications for inserting a wide bore nasogastric tube: • • • • • • • treat gastric distension or gastric outlet obstruction. relieve symptoms of intestinal obstruction. gastric/oesophageal tests. gastric lavage. administration of medications or nutrition. decompression of the stomach after GI surgery. Prevention of nausea and vomiting. Indications for inserting a fine bore nasogastric tube. • • Fine-bore nasogastric tubes (8 Fr to 12 Fr) are soft, flexible and have a small diameter. They are frequently used for enteral feeding for up to six weeks or for administration of medication to a patient with no gag reflex. contraindications to inserting a nasogastric tube. • • • nasopharyngeal or oesophageal obstruction. Faciomaxillary trauma fractured base of skull and deviated septum. Complications • • Minor: - Nose bleeds Curling of NG in the mouth Sinusitis Sore throat Gagging Vomiting - erosion of the soft tissue of the nose where the tube is secured. oesophageal perforation. pulmonary aspiration if the tube is dislodged. intracranial placement of the tube due to skull fractures. Major Methods of confirming the placement of a nasogastric tube • • • • • • X-ray -> gold standard. Aspirating gastric contents with the irrigation syringe and noting contents colour (e.g. green for bile). Aspirate should always be tested using a pH indicator strip / paper with 0.5 gradations or paper with a range of 0 to 6 or 1 to 11. Do not use litmus paper. Whilst listening over the epigastrium with a stethoscope quickly instil a 50cc airbolus with the irrigation syringe. Air entering the stomach will produce a “whooshing” sound. Ask the patient to hum or talk. Coughing, cyanosis, choking, or desaturation may indicate that the NG tube has passed through the larynx and into the lung. Place the open end of the NG tube in a cup of water. Persistent bubbling may indicate that the NG tube has passed through the larynx. With a fine bore tube once placement is confirmed by CKR only then the guide wire can be removed.