A nasogastric (NG) tube provides a conduit into the gastrointestinal (GI) tract (Figure 140).

Indications

1. ▪ Drainage of the GI tract.

2. ▪ Feeding the GI tract, thereby bypassing the oesophageal sphincters.

3. ▪ Sampling contents of upper GI tract.

Contraindications

1. ▪ Base of skull fracture – if suspected a nasogastric tube is contraindicated because it may pass through a fractured cribriform plate to enter the brain. An orogastric tube is the conduit of choice in this instance.

2. ▪ Patients with an unsecured airway – here a nasogastric tube may induce vomiting and lead to aspiration of gastric contents.

3. ▪ Facial fractures.

Types

1. ▪ Ryles tube – wide bore, used for short-term feeding or aspiration of gastric contents.

2. ▪ Fine-bore feeding tube – not for aspiration of gastric contents as its thin soft rubber walls have a tendency to collapse with minimal suction.

Insertion technique

Equipment required:

1. ▪ Universal protection equipment

2. ▪ Nasogastric tube (see above)

3. ▪ Lubricant (KY jelly/2% lidocaine gel)

4. ▪ Adhesive tape

5. ▪ Drainage bag

6. ▪ A 50 ml bladder suction syringe

7. ▪ Glass of water

8. ▪ Bowl for gastric contents

9. ▪ Stethoscope

10. ▪ Litmus paper.

Procedure:

1. Explain procedure and gain consent (verbal or written) from patient.

2. Sit patient upright.

3. Measure the distance from nostril to trans-pyloric plane (midpoint of line from sternal notch to symphisis pubis) and mark on tubing.

4. Lubricate the end of the tube.

5. If patient has an intact swallowing reflex, ask him/her to hold a sip of water in their mouth until instructed to swallow.

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