Nasogastric Tube Insertion and Removal

Nasogastric Tube Insertion and Removal

Usually inserted to decompress the stomach, a nasogastric (NG) tube can prevent vomiting after major surgery. An NG tube is typically in place for 48 to 72 hours after surgery, by which time peristalsis usually resumes. It may remain in place for shorter or longer periods, however, depending on its use.

The NG tube has other diagnostic and therapeutic applications, especially in assessing and treating upper GI bleeding, collecting gastric contents for analysis, performing gastric lavage, aspirating gastric secretions, and administering medications and nutrients.

Inserting an NG tube requires close observation of the patient and verification of proper placement. The tube must be inserted with extra care in pregnant patients and in those with an increased risk of complications. For example, the doctor will order an NG tube for a patient with aortic aneurysm, myocardial infarction, gastric hemorrhage, or esophageal varices only if he believes that the benefits outweigh the risks of intubation.

Most NG tubes have a radiopaque marker or strip at the distal end so that the tube’s position can be verified by X-ray. If the position can’t be confirmed, the doctor may order fluoroscopy to verify placement.

The most common NG tubes are the Levin tube, which has one lumen, and the Salem sump tube, which has two lumens—one for suction and drainage and a smaller one for ventilation. Air flows through the vent lumen continuously, which protects the delicate gastric mucosa by preventing a vacuum from forming should the tube adhere to the stomach lining. (See Types of NG tubes.)

Preparation of Equipment

Inspect the NG tube for defects, such as rough edges or partially closed lumens. Then check the tube’s patency by flushing it with water. If you need to increase the tube’s flexibility to ease insertion, coil it around your gloved fingers for a few seconds or dip it in
warm water. If the tube is too flaccid, stiffen it by filling the tube with water and then freezing it1 or dipping the tube in ice water.

Jul 21, 2016 | Posted by in NURSING | Comments Off on Nasogastric Tube Insertion and Removal

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