Chapter 10. Tubes and Devices A nasogastric (NG) tube is a hollow flexible plastic or silicone tube inserted through a nare, past the nasopharynx, oropharynx and into the stomach or the upper portion of the small intestine (the later referred to as naso-jejunum). NG tubes are used for feeding, gastric decompression, or gastric lavage. An NG tube used for feeding is usually softer and has a smaller lumen than tubes used for gastric suctioning / decompression. NG feeding tubes are used for patients who may have swallowing difficulties or require additional nutritional supplements. Placement of blindly inserted enteral tubes must be verified by x-ray before initial use for feedings or medication administration (Bourgault et al., 2014). Blindly inserted means there has not been direct visualization that the tube in the correct position. Sometimes normal peristalsis is interrupted (i.e., post op, in association with certain conditions). In these situations a naso gastric tube is used for gastric decompression. Removal of gastric contents can be done either by gravity or by being connected to a suction pump. In these situations, the NG tube is used to relieve gastric distention and in doing so prevent nausea and vomiting. In the event a patient swallows toxic substances, a nasogastric tube can be inserted and used to lavage or wash the stomach of its contents. NG tubes for these purposes generally have a larger lumen than tubes used for feeding purposes (Perry et al., 2018). Sometimes referred to as a Salem Sump or Levin, these tubes are double lumen. The main lumen is attached to suction, the second lumen acts as an air vent which prevents suctioning of gastric mucosa when the stomach is empty. When working with people who have nasogastric tubes, remember the following care measures:
Checklist 80 outlines the steps for inserting a nasogastric tube.
Special Considerations with NG Tubes:
Watch the video Insertion of a NG Tube developed by Renée Anderson and Wendy McKenzie (2018) of Thompon Rivers University School of Nursing. Removing a NG TubeA NG tube should be removed if it is no longer required. The process of removal is usually very quick. Prior to removing the NG tube, verify physician orders. If the NG tube is ordered to remove gastric contents, the physician’s order may state to “trial” clamping the tube for a number of hours to see if the patient tolerates oral intake or their own accumulation of gastric secretions prior to the tube removal. During the trial, the patient should not experience any nausea, vomiting, or abdominal distension. If they do experience these things, simply reattach the NG to suction. To review how to remove a NG tube, refer to Checklist 81.
Critical Thinking Exercises
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