NG tube

 From it word, nasogastric tube means that this special tube is inserted to the nose until it reach the stomach. It is usually has different sizes . 

What is the indication of inserting nasogastric tube?

• feeding for example in a case of dysphagia due to esophageal ca
• gastric aspiration which we can use to analyze the pH of the stomach
• stomach decompression in a case of intestinal obstruction
• use in unconscious patient esp to prevent aspiration pneumonia
• to make the bowel become inactive as the preparation for surgery

How long should we insert it? 

• there is a scale on the tube which guide us to measure tubing : from the bridge of nose to the earlobe until to the point halfway between the end of the sternum and the navel

STEPS

Wear a gloves

Patient should be in a sitting or 45 degree position. 

Once we had note the distance of it, put the lubricant gel and insert the tube to the nose. Please check first is there any nasal obstruction so that we can avoid from put it from there because we are actually causing trauma to the nasal part. 

Then we insert it to the posterior pharyngeal wall then continue until the patient will have a gag reflex . Ask the patient to swallow so that it would not enter the trachea. Finally u aspirate a sample of gastric contents. 

Do not inject an air bolus, as the best practice is to test the pH of the aspirated contents to ensure that the contents are acidic. The pH should be below 6

Secure tube with tape

Look for colour,nature and amount of the gastric contents

**In a unconscious patient, we use laryngoscope as an aid during the procedure and confirm the position of the tube by inject air and auscultate for air entry. Then do the x-ray.

Complications

• perforation of stomach
• aspiration pneumonia
• trauma
• pain
• loss of electrolytes
• oesophagitis
• necrosis