Nasogastric or Orogastric Tube

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Procedure Guidelines

9.23 NASOGASTRIC/OROGASTRIC TUBE

Contact Medical Control for Physician's Orders

INDICATIONS:

  • Gastric decompression

CONTRAINDICATIONS:

  • Absolute – Known or suspected esophageal varices
  • Relative – Ingestion of caustic poison

EQUIPMENT:

  • 14, 16 or 18 Fr. Levin tube, (for adults).
  • 35 cc syringe.
  • Water soluble lubrication gel.
  • Tape.
  • H2O.
  • Saline.

PRECAUTIONS:

  • It will be difficult and painful to pass tube on a patient with a deviated septum or nasal obstructions.
  • In conscious patients, gag reflex will be elicited. If patient gags, pause insertion allowing patient to take breaths or drink a few sips of water.
  • Epistaxis is a common complication.
  • If tube curls up inside pharynx, withdraw it and re-insert.
  • It is possible to inadvertently intubate trachea with NGT.

PROCEDURE:

CONTACT MEDICAL CONTROL FOR PHYSICIAN'S ORDERS.

  • Mark distance tube should be inserted by measuring from nose to ear lobe to below xyphoid process.
  • Lubricate distal 6 - 8" of NGT.
  • Examine nose for septal deviation. Use right nares if both nostrils are the same size.
  • Place patient in semi-fowler's position, if condition permits and slightly flex head.
  • Insert tube in nostril and gently pass tube into nose or thru King Tube.
  • Encourage patient to swallow as tube is advanced to pre-determined depth.
  • Confirm tube placement by aspirating gastric contents and by auscultating epigastrium while injecting 20 -30 cc air through tube.
  • Aspirate stomach contents and irrigate concomitantly, as ordered.
  • Tape tube in place and maintain suction if ordered.