1
CMCA RLE Module 1 - LESSON MATERIAL Dental
Materials (Centro Escolar University)
M1 : Lesson 1 : NGT insertion by L.Sadorra
Inserting a Nasogastric Tube
By inserting nasogastric tube you are gaining access to the stomach and its contents.
There are many types of nasogastric tubes that comes in different sizes. Among the most
common are the Levin catheter, which is single lumen, small bore tube more appropriate for
administration of medication or nutrition, invented by Abraham Louis Levin, an American
physician ( December 16, 1880- Sept 15, 1940.) The Levin tube is also widely used for
duodenal drainage after surgery and management of trauma patients. The Salem Sump
catheter, is a large bore double lumen tube that can be used for feeding or administering
medication, but their primary function is gastric suctioning and decompression.
Definition – A nasogastric tube is a flexible plastic tube inserted through the nostrils, down the
nasopharynx, and into the stomach or the upper portion of the small intestine. Placement of NG
tube is always confirmed by with an X ray prior to to use. ( Perry, Potter & Ostendorf, 2014.)
PURPOSES:
● To administer tube feedings and medications to clients unable to eat by mouth or
swallow a sufficient diet without aspirating food or fluids into the lungs
● To establish a means for suctioning stomach contents to prevent gastric distention,
nausea, and vomiting
● To remove stomach contents for laboratory analysis
● To lavage (wash) the stomach in case of poisoning or overdose of medications
ASSESSMENT
● Check for history of nasal surgery or deviated septum
● Assess patency of nares
● Determine presence of gag reflex
● Assess mental status or ability to participate in the procedure
PLANNING
Before inserting a nasogastric tube, determine the size of the tube to be inserted and whether the
tube is to be attached to a suction Equipment
● Large – or small-bore tube (nonlatex preferred )
● Non allergenic adhesive tape, 2.5 cm (1 in.) wide
● Clean gloves
● Water - soluble lubricant
● Facial tissues
pg. 1
, 2
● Glass of water and drinking straw
● 20 – 50 -ml syringe with an adapter
● Basin
● Ph test strip or meter
● Bilirubin dipstick
● Stethoscope
● Disposable pad or towel
● Suction apparatus
● Safety pin and elastic band
● C02 detector (optional) IMPLEMENTATION
Identifying the patient ensures the right
patient receives the intervention and helps
Preparation prevents errors. (Lynn, 20015)
● Assist the client to a high Fowler’s Explanation facilitates patient
position if his or her health cooperation
condition permits, and support the (Lynn, 2015)
head on a pillow.
● Place a towel or disposable pad
across the chest.
Performance
1. Prior to performing the insertion introduce
self and verify the client’s identity using two
patient's identifiers,(i.g., name and date of
birth.) Explain to the client what you are going
to do, why it is necessary, and how he or she
can participate. The passage of a gastric tube
is unpleasant because the gag reflex is
activated during insertion. Establish a method
for the client to indicate distress and a desire
for you to pause the insertion. Raising a finger
or a hand is often used for this.
Hand hygiene and PPE prevent the
2. Perform hand hygiene and observe other spread of microorganisms ( Lynn, 2015)
appropriate infection control procedures (e.g.,
clean gloves).
pg. 2
,3
3. Provide for client privacy Closing the door or pulling the curtain is the
client's right to privacy ( Carter, 2012 )
4. Assess the client’s nares
· Apply clean gloves
· Ask the client to hyperextend the head, and using a flashlight, observe the intactness of
the tissues of the nostrils, including any irritations or abrasions.
· Examine the nares for any obstructions or deformities by asking the client to breathe
through one nostril while occluding the other.
· Select the nostril that has the greater airflow.
5. Prepare the tube
● If a small bore-tube is being used, - An improperly positioned stylet or
ensure stylet or guidewire is guidewire can traumatize the nasopharynx,
secured in position. esophagus and stomach.
● If a large bore- tube (e.g Salem -This allows the tubing to become more
sump tube) is being used, place pliable and flexible. However, if the softened
the tube in a basin of warm water, tube becomes difficult to control, it may be
while preparing the client helpful to place the distal end in a basin of
ice water to help it hold its shape.
pg. 3
, 4
-This length approximates the distance from
6. Determine how far to insert the tube. the nares to the stomach. This distance varies
● Use the tube to mark off the among individuals.
distance from the tip of the client’s
nose to the tip of the earlobe to the
tip of the xiphoid
● Mark this length with adhesive
tape if the tube does not have
markings
pg. 4
CMCA RLE Module 1 - LESSON MATERIAL Dental
Materials (Centro Escolar University)
M1 : Lesson 1 : NGT insertion by L.Sadorra
Inserting a Nasogastric Tube
By inserting nasogastric tube you are gaining access to the stomach and its contents.
There are many types of nasogastric tubes that comes in different sizes. Among the most
common are the Levin catheter, which is single lumen, small bore tube more appropriate for
administration of medication or nutrition, invented by Abraham Louis Levin, an American
physician ( December 16, 1880- Sept 15, 1940.) The Levin tube is also widely used for
duodenal drainage after surgery and management of trauma patients. The Salem Sump
catheter, is a large bore double lumen tube that can be used for feeding or administering
medication, but their primary function is gastric suctioning and decompression.
Definition – A nasogastric tube is a flexible plastic tube inserted through the nostrils, down the
nasopharynx, and into the stomach or the upper portion of the small intestine. Placement of NG
tube is always confirmed by with an X ray prior to to use. ( Perry, Potter & Ostendorf, 2014.)
PURPOSES:
● To administer tube feedings and medications to clients unable to eat by mouth or
swallow a sufficient diet without aspirating food or fluids into the lungs
● To establish a means for suctioning stomach contents to prevent gastric distention,
nausea, and vomiting
● To remove stomach contents for laboratory analysis
● To lavage (wash) the stomach in case of poisoning or overdose of medications
ASSESSMENT
● Check for history of nasal surgery or deviated septum
● Assess patency of nares
● Determine presence of gag reflex
● Assess mental status or ability to participate in the procedure
PLANNING
Before inserting a nasogastric tube, determine the size of the tube to be inserted and whether the
tube is to be attached to a suction Equipment
● Large – or small-bore tube (nonlatex preferred )
● Non allergenic adhesive tape, 2.5 cm (1 in.) wide
● Clean gloves
● Water - soluble lubricant
● Facial tissues
pg. 1
, 2
● Glass of water and drinking straw
● 20 – 50 -ml syringe with an adapter
● Basin
● Ph test strip or meter
● Bilirubin dipstick
● Stethoscope
● Disposable pad or towel
● Suction apparatus
● Safety pin and elastic band
● C02 detector (optional) IMPLEMENTATION
Identifying the patient ensures the right
patient receives the intervention and helps
Preparation prevents errors. (Lynn, 20015)
● Assist the client to a high Fowler’s Explanation facilitates patient
position if his or her health cooperation
condition permits, and support the (Lynn, 2015)
head on a pillow.
● Place a towel or disposable pad
across the chest.
Performance
1. Prior to performing the insertion introduce
self and verify the client’s identity using two
patient's identifiers,(i.g., name and date of
birth.) Explain to the client what you are going
to do, why it is necessary, and how he or she
can participate. The passage of a gastric tube
is unpleasant because the gag reflex is
activated during insertion. Establish a method
for the client to indicate distress and a desire
for you to pause the insertion. Raising a finger
or a hand is often used for this.
Hand hygiene and PPE prevent the
2. Perform hand hygiene and observe other spread of microorganisms ( Lynn, 2015)
appropriate infection control procedures (e.g.,
clean gloves).
pg. 2
,3
3. Provide for client privacy Closing the door or pulling the curtain is the
client's right to privacy ( Carter, 2012 )
4. Assess the client’s nares
· Apply clean gloves
· Ask the client to hyperextend the head, and using a flashlight, observe the intactness of
the tissues of the nostrils, including any irritations or abrasions.
· Examine the nares for any obstructions or deformities by asking the client to breathe
through one nostril while occluding the other.
· Select the nostril that has the greater airflow.
5. Prepare the tube
● If a small bore-tube is being used, - An improperly positioned stylet or
ensure stylet or guidewire is guidewire can traumatize the nasopharynx,
secured in position. esophagus and stomach.
● If a large bore- tube (e.g Salem -This allows the tubing to become more
sump tube) is being used, place pliable and flexible. However, if the softened
the tube in a basin of warm water, tube becomes difficult to control, it may be
while preparing the client helpful to place the distal end in a basin of
ice water to help it hold its shape.
pg. 3
, 4
-This length approximates the distance from
6. Determine how far to insert the tube. the nares to the stomach. This distance varies
● Use the tube to mark off the among individuals.
distance from the tip of the client’s
nose to the tip of the earlobe to the
tip of the xiphoid
● Mark this length with adhesive
tape if the tube does not have
markings
pg. 4
