NASOGASTRIC TUBE FEEDING
Definition
A nasogastric tube (NGT) is a flexible plastic tube inserted through the nostrils,
down the nasopharynx, and into the stomach or the upper portion of the small
intestine. It is often inserted before or during surgery or at the bedside.
NGT is used to:
• Administer medication and feeding
• Deliver nutrients to the patient via a feeding pump
• Remove gastric contents either by gravity or by connecting it to a suction
pump
• Prevent gastric distension,
• Remove toxins from the stomach.
Equipment Type 1
• NGT 16 French - for feeding and medication, decompression
• Syringe10.20 cc- aspiration and checking placement
• Gloves
• Lubricating jelly for easily insertion
• Fixation tape plaster
• Stethoscope - checking placement
• Bowl with gauze piece- is an aspiration appears for cleaning purpose
• Bowl with water- checking placement
• Kidney tray - for collection of and aspiration
• Mackintosh with towel prevention of soiled of the patients
• Pen light
• Markers
The NGT =40- In to cardio sphincters, 50-in to stomach, 60-in to pylorus, 70-in to
duodenum
Type 2
• Tray or trolley – to arrange all articles neatly
• Nasogastric tube (Ryle’s tube) – appropriate size for the patient
, • Lubricant (water-soluble jelly or glycerin)
• Clean gloves (sterile if required)
• Adhesive tape or plaster – for fixing the tube to the nose
• Antiseptic solution (like Savlon or spirit) – for cleaning the nostril
• Towel or Mackintosh and draw sheet – to protect patient’s clothes and bed
• Kidney tray or emesis basin – in case of vomiting
• Glass of drinking water with a straw – if patient is conscious (to help
swallowing)
• 50 mL syringe (catheter tip) – for checking tube placement or for feeding
• Measuring tape – to measure the length of insertion
• Stethoscope – for checking air entry in the stomach
• Scissors – to cut tape or plaster
• Suction machine (if necessary for removing secretions)
• pH paper (if available) – to test aspirate and confirm placement
Procedure
1. Gather requirements
2. Perform hand hygiene
3. Visually inspect condition of patient's nasal and oral cavities
4. Inspect the nostrils for any obstruction or growth.
5. Assess for the best nostril before you begin
6. Measure the tube length to be inserted; mark the measured length with a marker
7. Lubricate the nostril with
8. Palpate patient's abdomen for distension, pain, and/or rigidity.
9. Auscultate for bowel sounds.
10. Assess patient's level of consciousness and understanding of procedure.
11. Position patient sitting up at 45 to 90 degrees (unless contraindicated by the
patient's condition), with a pillow under the head and shoulders.
12. Raise bed to a comfortable working height.
13. Place a towel on the patient's chest and provide facial tissues and an emesis
basin.
14. Stand on patient's right side if you are right-handed and the left side if you are
left-handed.
,15. Measure distance of the tube from the tip of the nose; earlobe to then the
xiphoid process
and then mark the tube at this point.
16. Wear your gloves.
17. Lubricate the tip of the NGT.
18. Curve 10 to 15 cm of the end of the NGT around your gloved finger, and then
release it.
19. Have patient drop head forward and breathe through the mouth.
20. Insert NGT tip slowly into the patient's nostril and advance it steadily, in a
downward direction, along the bottom of the nasal passage, with the curved end
pointing downward in the direction of the ear on the same side as the nostril.
21. Instruct patient to swallow and advance the tube as the patient swallows
22. If resistance is met rotate the tube slowly as you advancing downwards, and
continue trying to advance the tube do not force it through.
23. If significant resistance is felt, remove the tube and allow the patient to rest
before trying again in the other nostril.
24. If there is difficulty in passing the NG tube, you may ask the patient to sip
water slowly through a straw unless oral fluids are contraindicated. If oral fluids
are not allowed, ask the patient to try dry swallowing while you advance the tube.
25. Continue to advance NGT until you reach the mark/tape you had placed for
measurement.
26. Temporarily anchor the tube to patient's cheek with a piece of tape until you
can check for correct placement.by doing the following:
27. Test for PH: aspirate the gastric content and place on a litmus paper
28. Withdraw content to check for stomach content
29. Put the outer part of the NGT in a bowl of water in a gallipot, bubbles indicate
it's in the lungs
30. Confirm the tube placement
31. Once the tube placement has been confirmed, mark (with a permanent marker)
and record the length of tubing extending from the nose to the outer end of the
tube.
32. Secure the tube to the patient's gown with a safety pin, allowing enough tube
length for comfortable head movement. Oe to the nose R use a plaster and strap
tub.
, 33. Document the procedure.
Indication
• Deliver nutrients to the patient via a feeding pump
• Remove gastric contents
• By inserting a nasogastric tube, you are gaining access to the stomach and its
contents.
• decompress the stomach,
• obtain a specimen of the gastric contents, or
• introduce a passage into the Gl tract to treat gastric immobility, and bowel
obstruction.
• It will also allow for drainage and/or lavage in drug overdosage or
poisoning.
• In trauma settings, NG tubes can be used to aid in the
• prevention of vomiting and aspiration,
• assessment of Gl bleeding. (presence and volume)
NG tubes can also be used for enteral feeding initially.
Contraindication
• Gastro-esophageal reflux
• Nasal injuries
• Upper gastro intestinal strictures
• base of skull fractures, severe facial fractures especially to the nose
• obstructed esophagus, esophageal varices, and/or obstructed airway
• who have had gastric bypass surgery
NASO GASTRIC TUBE INSERTION AND REMOVAL
Basic Concept: A tube that is inserted through the nose, down the throat and
esophagus, and into the stomach. It can be used to give drugs, liquids, and liquid
food, or used to remove substances from the stomach. Giving food through a
nasogastric tube is a type of enteral nutrition. Also called gastric feeding tube and
NG tube.
Definition
A nasogastric tube (NGT) is a flexible plastic tube inserted through the nostrils,
down the nasopharynx, and into the stomach or the upper portion of the small
intestine. It is often inserted before or during surgery or at the bedside.
NGT is used to:
• Administer medication and feeding
• Deliver nutrients to the patient via a feeding pump
• Remove gastric contents either by gravity or by connecting it to a suction
pump
• Prevent gastric distension,
• Remove toxins from the stomach.
Equipment Type 1
• NGT 16 French - for feeding and medication, decompression
• Syringe10.20 cc- aspiration and checking placement
• Gloves
• Lubricating jelly for easily insertion
• Fixation tape plaster
• Stethoscope - checking placement
• Bowl with gauze piece- is an aspiration appears for cleaning purpose
• Bowl with water- checking placement
• Kidney tray - for collection of and aspiration
• Mackintosh with towel prevention of soiled of the patients
• Pen light
• Markers
The NGT =40- In to cardio sphincters, 50-in to stomach, 60-in to pylorus, 70-in to
duodenum
Type 2
• Tray or trolley – to arrange all articles neatly
• Nasogastric tube (Ryle’s tube) – appropriate size for the patient
, • Lubricant (water-soluble jelly or glycerin)
• Clean gloves (sterile if required)
• Adhesive tape or plaster – for fixing the tube to the nose
• Antiseptic solution (like Savlon or spirit) – for cleaning the nostril
• Towel or Mackintosh and draw sheet – to protect patient’s clothes and bed
• Kidney tray or emesis basin – in case of vomiting
• Glass of drinking water with a straw – if patient is conscious (to help
swallowing)
• 50 mL syringe (catheter tip) – for checking tube placement or for feeding
• Measuring tape – to measure the length of insertion
• Stethoscope – for checking air entry in the stomach
• Scissors – to cut tape or plaster
• Suction machine (if necessary for removing secretions)
• pH paper (if available) – to test aspirate and confirm placement
Procedure
1. Gather requirements
2. Perform hand hygiene
3. Visually inspect condition of patient's nasal and oral cavities
4. Inspect the nostrils for any obstruction or growth.
5. Assess for the best nostril before you begin
6. Measure the tube length to be inserted; mark the measured length with a marker
7. Lubricate the nostril with
8. Palpate patient's abdomen for distension, pain, and/or rigidity.
9. Auscultate for bowel sounds.
10. Assess patient's level of consciousness and understanding of procedure.
11. Position patient sitting up at 45 to 90 degrees (unless contraindicated by the
patient's condition), with a pillow under the head and shoulders.
12. Raise bed to a comfortable working height.
13. Place a towel on the patient's chest and provide facial tissues and an emesis
basin.
14. Stand on patient's right side if you are right-handed and the left side if you are
left-handed.
,15. Measure distance of the tube from the tip of the nose; earlobe to then the
xiphoid process
and then mark the tube at this point.
16. Wear your gloves.
17. Lubricate the tip of the NGT.
18. Curve 10 to 15 cm of the end of the NGT around your gloved finger, and then
release it.
19. Have patient drop head forward and breathe through the mouth.
20. Insert NGT tip slowly into the patient's nostril and advance it steadily, in a
downward direction, along the bottom of the nasal passage, with the curved end
pointing downward in the direction of the ear on the same side as the nostril.
21. Instruct patient to swallow and advance the tube as the patient swallows
22. If resistance is met rotate the tube slowly as you advancing downwards, and
continue trying to advance the tube do not force it through.
23. If significant resistance is felt, remove the tube and allow the patient to rest
before trying again in the other nostril.
24. If there is difficulty in passing the NG tube, you may ask the patient to sip
water slowly through a straw unless oral fluids are contraindicated. If oral fluids
are not allowed, ask the patient to try dry swallowing while you advance the tube.
25. Continue to advance NGT until you reach the mark/tape you had placed for
measurement.
26. Temporarily anchor the tube to patient's cheek with a piece of tape until you
can check for correct placement.by doing the following:
27. Test for PH: aspirate the gastric content and place on a litmus paper
28. Withdraw content to check for stomach content
29. Put the outer part of the NGT in a bowl of water in a gallipot, bubbles indicate
it's in the lungs
30. Confirm the tube placement
31. Once the tube placement has been confirmed, mark (with a permanent marker)
and record the length of tubing extending from the nose to the outer end of the
tube.
32. Secure the tube to the patient's gown with a safety pin, allowing enough tube
length for comfortable head movement. Oe to the nose R use a plaster and strap
tub.
, 33. Document the procedure.
Indication
• Deliver nutrients to the patient via a feeding pump
• Remove gastric contents
• By inserting a nasogastric tube, you are gaining access to the stomach and its
contents.
• decompress the stomach,
• obtain a specimen of the gastric contents, or
• introduce a passage into the Gl tract to treat gastric immobility, and bowel
obstruction.
• It will also allow for drainage and/or lavage in drug overdosage or
poisoning.
• In trauma settings, NG tubes can be used to aid in the
• prevention of vomiting and aspiration,
• assessment of Gl bleeding. (presence and volume)
NG tubes can also be used for enteral feeding initially.
Contraindication
• Gastro-esophageal reflux
• Nasal injuries
• Upper gastro intestinal strictures
• base of skull fractures, severe facial fractures especially to the nose
• obstructed esophagus, esophageal varices, and/or obstructed airway
• who have had gastric bypass surgery
NASO GASTRIC TUBE INSERTION AND REMOVAL
Basic Concept: A tube that is inserted through the nose, down the throat and
esophagus, and into the stomach. It can be used to give drugs, liquids, and liquid
food, or used to remove substances from the stomach. Giving food through a
nasogastric tube is a type of enteral nutrition. Also called gastric feeding tube and
NG tube.
