Nasogastric or Orogastric Tube

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.