Nasogastric tube

NG Tube Indications

•Aspirate stomach contents• Diagnostic or therapeutic

•Assessment of GI bleeding•Determine gastric acid content

NG Tube Indications

• Treat paralytic ileus • Treat intestinal obstruction• Recurrent vomiting likely• Trauma• Overdose

NG Tube Contraindications

• Esophageal strictures• Alkali ingestion, caustic ingestions, esophageal burns

NG Tube Contraindications

• Trauma patients with:• Cervical or intracranial bleeding• Increased intracranial pressure

• Recent surgery of the following types:• Oropharyngeal• Nasal• Gastric

Confirm NG Tube Placement

• X-ray• Most reliable if tube is radiopaque• Requires order from physician

• Injecting air• 60 cc catheter syringe• Place stethoscope over LUQ of abdomen• Inject air into lumen of tube• Listen for “swoosh” sound

Confirm NG Tube Placement

•Test pH of gastric aspirate•pH < 4 = 95% chance that tip is in stomach•pH > 6 = may be in lung or pleural space

Complications

Excessive coughing, motion, gagging may aggravate the following:

•Neck injuries• Increased risk for C-spine injuries

•Penetrating neck wounds• May increase hemorrhage

• Tube misplacement• Pulmonary• Intracranial

Nasogastric Tube Position

Evaluation

• Note location of external site marking on the tube• Documentation • Size of tube, which nostril and client’s response.• Record length of tube from the nostril to end of tube• Record aspirate pH and characteristics

X-ray of misplaced NG tube