Nasogastric Intubation

WHAT YOU SHOULD KNOW:

  • Nasogastric intubation is a procedure to insert a nasogastric (NG) tube into your nose down into your stomach. An NG tube is a long, thin, bendable plastic or rubber tube with holes at both ends. Depending on the type of NG tube, it may help remove air or excess fluids out of the stomach. It may also be used as a way to bring food to your stomach. Medicines and other substances, such as activated charcoal or dye, may also be given through an NG tube. Use of this tube should only be temporary (short time).

  • You may need an NG tube if your stomach gets too full or if you throw up a lot after surgery. An NG tube may also be useful in food poisoning or drug overdose. Sometimes, an NG tube is placed to get samples of fluid from the stomach for testing. This is done particularly if caregivers want to check for bleeding.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Having a nasogastric intubation may carry certain risks. There may be bleeding, infection, or injury to the parts where the tube will pass through. The tube may enter the wrong place, such as the lungs, and cause breathing problems. If part of the skull (head) is broken, the tube may enter the brain. Medicines, including anesthesia, that are used during the procedure may cause an allergy. Over time, the NG tube may move which may lead to lung problems or indigestion. Patients with a head injury, nose or esophagus problems, or problems swallowing are at a higher risk for problems. You may not have an NG tube if you just had an injury to your upper jaw or face. Patients who cannot cooperate or are not conscious may also not have an NG tube. Talk with your caregiver if you are worried or have questions about your procedure, medicine, or care.

WHILE YOU ARE HERE:

Before your procedure:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Local anesthesia is medicine used to numb an area of your body that will have surgery or a procedure. The medicine may be given in an injection, cream, gel, or patch.

During your procedure:

  • You are asked to sit up with your neck bent forward. Your caregiver will choose which nostril (opening of the nose) will be better to put the NG tube into. You may be given medicine to numb the area where the NG tube will pass. Medicine to make your blood vessels in the nose get smaller and prevent bleeding may also be given. Your caregiver will measure the length of the tube needed to reach your stomach. This area may then be marked using tape. Sterile (clean) jelly or water is placed around the end of the tube to help it slide down. A nasendoscope (a long thin tube passed through the nose and down into the esophagus) may be used as guide.

  • With your head straight up, neck slightly tilted forward, and facing forward, the NG tube is gently put into your nostril. The tube will pass through your nostril, throat, esophagus, and into your stomach. You may cough or feel like throwing up as the tube reaches your throat. Swallowing may help the tube slide down easily and avoid going into your lungs. Caregivers may ask you to take sips of water and to tilt your head forward. Tell your caregiver right away if you cannot breathe.

  • Your caregiver pushes down the tube until the taped mark reaches the nostril. Certain steps are done to check if the tube is in its proper place. Air may be blown in the tube while the sound it makes in the stomach is checked. Some fluids may be taken and tested for its acidity and content. An x-ray of the abdomen (stomach) may also be done. To keep the tube in place, it will be taped to your nose. The part of the tube that is hanging down will be pinned to your hospital gown.

After your procedure:

  • Monitoring:

    • Intake and output: Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.

    • NG tube: Different devices may be attached to the NG tube. This will depend on the purpose of the tube insertion. If your stomach needs to be emptied, a suction (vacuum) may be connected to it. If the tube is mainly a way to feed the patient or give medicines, a feeding pump may be used. While the tube is inserted, caregivers will check on the tube regularly to make sure it stays in the proper place. This may be done by sucking fluid out of the tube and testing for its content or acidity. If the tube seems to be blocked, it may have to be flushed with saline (salt-water solution) or blown with air. Tape used to secure the NG tube may have to be checked everyday or whenever it becomes soaked.

    • Skin and abdomen: Your skin in the area of tube insertion will be checked often to make sure it is not causing sores or problems. Caregivers will look for redness, swelling, drainage, or bleeding at the site of insertion. Your abdomen (stomach) will also be checked often to make sure that it is not getting hard or bloated.

    • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

  • Removing the NG tube: Taking out the NG tube may be easier than putting it in. However, you may still experience the same uncomfortable feeling while the tube is being taken out. This includes feeling like you want to vomit (throw up). Your caregiver may do the following steps in taking out the NG tube:

    • Your caregiver will turn off and disconnect any device that is attached to the NG tube. This may include the suction machine or feeding pump.

    • You will be asked to sit up and a towel will be put over your chest.

    • Tapes or other materials used to secure the tube will be taken away. The tube will also be removed from the hospital gown.

    • With gloves on, your caregiver will gently and quickly pull out the tube from your nose. The tube is then wrapped in a towel and disposed off properly.

    • The area where the NG tube was placed will be cleaned. Mouth and nasal care may also be given.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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