A nasogastric tube can be used to access a patient's stomach.NG tubes can be used to drain the stomach, take samples, and distribute medications.The process of putting the tube in is easy, but must be done carefully to avoid irritation.
Step 1: Put gloves on.
Before the procedure, you should wash your hands and put on a pair of gloves.Even though you have gloves on, you should still wash your hands with warm water and antibacterial soap to reduce the risk of introducing germs into the nasogastric tube.
Step 2: Explain the procedure to the patient.
Explain the procedure to the patient.You need the patient's consent to continue.It is possible to gain the trust of the patient by talking them through the procedure.
Step 3: The patient should be moved.
The patient should be positioned in an upright sitting position with his or her chin touching the chest.The person should face forward.If the patient has a hard time holding his or her head up, you may need someone to help you.The head can be held steady with stiff pillows.The baby can be laid back instead of being held in an upright sitting position if you place anNG tube in him.The baby's face should be raised and his chin raised.
Step 4: Take a look at the nostrils.
Check both nostrils for signs of obstruction.You need to insert the tube into the clearest nostril.Look into the nostrils with a small flashlight or similar light.
Step 5: Measure the length of the tube.
Measure the tube length by drawing the tubing across the patient's body.Start at the bridge of the nose and draw the tube across the face to the ear.The tube lies halfway between the end of the sternum and the navel.The lower ribs meet at the center front of the body.There is a point beneath the chest bone for an infant.Measure two fingers for a child.Teenagers and adults can have different distances depending on their height.Use permanent marker to write down the measurement on the tube.
Step 6: The patient's throat needs to be numb.
The back of the patient's throat should be sprayed.Wait a few seconds for the spray to start.The use of throat spray can make this procedure more comfortable for many patients.It is not necessary.
Step 7: The tube should be Lubricated.
The water-based lubricant should be applied to the first 2 to 4 inches of the NG tube.The use of a lubricant containing 2-percent Xylocaine can further reduce irritation.
Step 8: The tube should be inserted into a nostril.
Feed the lubricated end of the tube straight back into the clearest nostril you can find.The patient is looking straight at you.The tube should be directed toward the ear on the other side of the head.The tube shouldn't be allowed to feed into the brain.If you feel resistance, stop.Try the other nostril.The tube should never be pushed inward.
Step 9: The back of the throat needs to be checked.
If you have coated the patient's throat with throat spray, you should ask them to open their mouth and look for the other end of the tube.If patients were not treated with throat spray, opening the mouth might be too painful.The patient should be asked when he or she feels the tube at the back of the throat.Guide the patient's head so that the chin touches the chest as soon as the tube hits the top of the throat.This can encourage the tube to go into the esophagus.
Step 10: The patient should be told to swallow.
The patient should get a glass of water.As you continue guiding the tube downward, ask him or her to take small sips and swallows.If the patient is unable to drink water for any reason, you should encourage him or her to dry swallow as you feed the tube into the throat.The patient should be given a pacifier to encourage them to suck and swallow.
Step 11: Once you reach the mark, stop.
Continue feeding the tube until it reaches the patient's nostril.If you meet resistance further into the throat, slowly rotating the tube as you advance it.This should help.Pull the tube out if it still gives resistance.Don't force it in.If you notice a change in the patient's respiratory status, stop immediately and remove the tube.Difficult breathing can be included.The tube has been inserted into the trachea by mistake, according to a change in respiratory status.If the tube comes out of the patient's mouth, you should remove it.
Step 12: Put air in the tube.
The air should be inserted into the tube with a clean, dry syringe.Listen for the sound it makes using a stethoscope.Attach the syringe to the open end of the tube if you want to collect air.A stethoscope should be placed over the patient's stomach, just below the ribs, and on the left side of the body.To get the air into the tube, depress the plunger.If the tube has been positioned correctly, you should hear a popping sound through the stethoscope.If you suspect improper placement, remove the tube.
Step 13: pirate from the tube
If you want to test the contents of the tube, use a needle to draw stomach acid through it.Attach the needle to the free end of the tube.The stomach contents need to be drawn into the tube.Wet the paper with the sample and compare the color on the strip to the corresponding color chart.If the pH is too high or if you suspect improper placement, remove the tube.
Step 14: The tube needs to be secured.
To secure the placement of the tube, tape it to the patient's skin with thick medical tape.Wrap the ends of the tape around the tube and attach it to the patient's nose.There is a piece of tape across the tube and over the patient's cheek.The tube cannot be moved as the patient moves his or her head.
Step 15: The patient's level of comfort should be checked.
Before leaving the patient, make sure he or she is comfortable.The patient should be helped into a comfortable resting position.Make sure the tube isn't cut off.You should be able to wash your hands once the patient is comfortable.You can wash your hands by throwing the gloves away in a clinical waste bin.
Step 16: An x-ray is needed to confirm the placement.
The tube is likely positioned correctly if the air test and stomach contents check out.A chest x-ray is a good way to confirm the placement of the tube.Before using the tube to deliver food or medication, you should do this.Proper placement can be confirmed by a doctor or nurse after the x-ray results are delivered.
Step 17: The tube can be used as needed.
You should be able to use the tube to drain the stomach at this point.If you want to drain out the fluids from the tube, you'll need to attach a bile bag to it.Attach the end of the tube to the machine.The machine should be set as per the patient's needs.If you want to use the NG tube for food or medicine, you'll need to remove the guide wire from inside.Carefully pull the guide wire out after you flush 1 to 2 liters of water through the tube.Store the wire in a sterile location after cleaning and drying it.Regardless of what the tube is used for, you should document its usage closely.All medical details relating to the usage of the tube should be written down.