Skill 44
Nasogastric Tube for Gastric Decompression
Insertion and Removal
There are times following major surgery or with conditions affecting the gastrointestinal (GI) tract when normal peristalsis is temporarily altered. Because peristalsis is slowed or absent, a patient cannot eat or drink fluids without causing abdominal distention. The temporary insertion of a nasogastric (NG) tube into the stomach serves to decompress the stomach, keeping it empty until normal peristalsis returns.
The Levin and Salem sump tubes are the most common for stomach decompression. The Levin tube is a single-lumen tube with holes near the tip. You connect the tube to a drainage bag or an intermittent suction device to drain stomach secretions. The Salem sump tube is preferable for stomach decompression. The tube has two lumens: one for removal of gastric contents and one to provide an air vent. A blue “pigtail” is the air vent that connects with the second lumen. When the main lumen of the sump tube is connected to suction, the air vent permits free, continuous drainage of secretions. Never clamp off the air vent, connect to suction, or use for irrigation.
Delegation Considerations
The skill of inserting and maintaining an NG tube cannot be delegated to nursing assistive personnel (NAP). The nurse directs the NAP to:
▪ Measure and record the drainage from an NG tube.
▪ Provide oral and nasal hygiene measures.
▪ Perform selected comfort measures, such as positioning or offering ice chips if allowed.
▪ Anchor the tube to the patient’s gown during routine care to prevent accidental displacement.
Equipment
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