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Nasogastric tubesNG Tube IndicationsAspirate stomach contentsDiagnostic or therapeutic

Assessment of GI bleedingDetermine gastric acid content

NG Tube IndicationsTreat paralytic ileus Treat intestinal obstructionRecurrent vomiting likelyTraumaOverdose

Determine length of tube to be inserted Tube placement must be confirmed before use.Following initial x-ray film confirmation; verify tube position every 4 to 6 hours and as needed.Observe characteristics of fluid aspirated from tube.Test the pH of aspirated fluid.Tube irrigation maintains tube patency:Before, between, and after medications and feedings.30 mL of plain water is the preferred irrigation solution.

Allow gravity infusion of irrigating solution.Verifying Feeding Tube Placement and IrrigationConfirm NG Tube PlacementX-rayMost reliable if tube is radiopaqueRequires order from physicianInjecting air60 cc catheter syringePlace stethoscope over LUQ of abdomenInject air into lumen of tubeListen for swoosh soundConfirm NG Tube PlacementTest pH of gastric aspiratepH < 4 = 95% chance that tip is in stomachpH > 6 = may be in lung or pleural space

Nasogastric Tube Position

NG Tube ContraindicationsEsophageal stricturesAlkali ingestion, caustic ingestions, esophageal burns

NG Tube ContraindicationsTrauma patients with:Cervical or intracranial bleedingIncreased intracranial pressure

Recent surgery of the following types:OropharyngealNasalGastric ComplicationsExcessive coughing, motion, gagging may aggravate the following:Neck injuriesIncreased risk for C-spine injuriesPenetrating neck woundsMay increase hemorrhageTube misplacementPulmonaryIntracranial

X-ray of misplaced NG tube

Evaluation Note location of external site marking on the tubeDocumentation Size of tube, which nostril and clients response.Record length of tube from the nostril to end of tubeRecord aspirate pH and characteristics