NG tube insertion

Indications

Drain stomach (eg. prior to surgery), feeding

Equipment

NG tube, lidocaine jelly, large bore syringe, litmus paper, drainage bag, receiver or vomit bowl, adhesive tape

Routine

1. Introduce & explain
2. Position pt sitting up, protect their clothing w a towel
3. Estimate length of tube: distance from pt's nose to the tip of the earlobe & then to the tip of the xiphisternum & mark this distance on the tube
4. Pt blows nose. Select best nostril
5. Lubricate end of tube & place in nostril, advancing along floor to nasopharynx
6. As enters pharynx ask pt to take sip of water & swallow as advance tube into oesophagus
7. In stomach: aspirate fluid w syringe + test w litmus paper (blue→pink)
8. Insert 10-20ml air into tube whilst colleague listens w stephoscope to hear gurgling
9. CXR necessary before feeding (cos cant aspirate through thin-bore)

Complications 

Pain, trauma, perforation of stomach, tracheal/duodenal intubation, aspiration, GO reflux, local trauma