Nasogastric (NG) Tube Insertion
NG tubes may be used for feeding or drainage. You will be inserting a tube from the
patient’s nose into their stomach.
This skill is important to know as a medical student. Most medical schools will have
mannequins to practice this skill on.
Steps:
1. Wash your hands, introduce yourself to the patient and clarify the patient’s
identity. Explain the procedure and obtain their consent before proceeding.
2. Make sure you have all the equipment:
Gloves
Fine bore nasogastric tube (for feeding) or nasogastric ‘Ryles’ tube
16Fr (for all other uses)
Water based lubricant
Syringe
Bile bag
Securing device or tape
Cup of water
pH indicator paper
Anaesthetic throat spray
3. The patient should be positioned on the bed in an upright position and facing
forward. Put on your gloves before proceeding.
4. Estimate the length of the tube to be inserted. Do this by measuring the NG
tube from the tip of the nose to the earlobe and then to the xiphisternum.
5. Lubricate the tip of the NG tube and begin to insert it through one of the
nostrils. If you encounter any resistance, change to the other nostril.
The patient will usually be awake during the procedure so ensure they are not
experiencing too much pain.
6. Ask the patient to indicate to you when the NG tube touches the back of their
throat. If the patient has had anaesthetic throat spray, ask them to open their
mouth so you can look at the end of the tube.
7. At this point, ask the patient to take a mouthful of water and as they swallow,
advance the tube to the desired length.
8. Then aspirate from the tube with the syringe. Test the aspirated fluid with the
pH indicator paper. If the pH is low, this tells you the NG tube is in the
stomach.
NG tubes may be used for feeding or drainage. You will be inserting a tube from the
patient’s nose into their stomach.
This skill is important to know as a medical student. Most medical schools will have
mannequins to practice this skill on.
Steps:
1. Wash your hands, introduce yourself to the patient and clarify the patient’s
identity. Explain the procedure and obtain their consent before proceeding.
2. Make sure you have all the equipment:
Gloves
Fine bore nasogastric tube (for feeding) or nasogastric ‘Ryles’ tube
16Fr (for all other uses)
Water based lubricant
Syringe
Bile bag
Securing device or tape
Cup of water
pH indicator paper
Anaesthetic throat spray
3. The patient should be positioned on the bed in an upright position and facing
forward. Put on your gloves before proceeding.
4. Estimate the length of the tube to be inserted. Do this by measuring the NG
tube from the tip of the nose to the earlobe and then to the xiphisternum.
5. Lubricate the tip of the NG tube and begin to insert it through one of the
nostrils. If you encounter any resistance, change to the other nostril.
The patient will usually be awake during the procedure so ensure they are not
experiencing too much pain.
6. Ask the patient to indicate to you when the NG tube touches the back of their
throat. If the patient has had anaesthetic throat spray, ask them to open their
mouth so you can look at the end of the tube.
7. At this point, ask the patient to take a mouthful of water and as they swallow,
advance the tube to the desired length.
8. Then aspirate from the tube with the syringe. Test the aspirated fluid with the
pH indicator paper. If the pH is low, this tells you the NG tube is in the
stomach.
