Nasogastric tube placement

1. Wash hands 2. Knock door 3. Introduce myself (hello, my name is Yary, Im a student nurse and I'm going to be placing a nasogastric tube, (which is a tube through your nose to the stomach for food, medication or to remove contents of the stomach including air) May I see your ID please? (Full name and DOB). Do you have any allergy? Give me just a minute Im going to wash my hands and gather the supplies.4. Equipment needed: NG kit (lubricant, cup, straw, tincture of benzoin, bin, syringe) Gloves Stethoscope Pen light Tongue depressor Alcohol swab Towel 5. Raise patient bed to waist level, and High Fowlers position. Explain It is going to be a little uncomfortable that is why please follow my directions and try to relax. 6. Put on gloves. 7. Follow physicians order and set the suction to continuous or intermittent and at the ordered (80-120 mm of mercury) and occlude the blue tubing. Turn it off. 8. Take the tape and cut 1 piece in almost half (like a pant), a bigger one to paste to the side of the face, a smaller one for the nose, and a little one for the tube. Paste it on the table. 9. Take the penlight and inspect the inside of the nose. Ask the patient if he has had any nose procedure, deviated septum, nosebleeds, polyps? Assess patency of the nostrils. Occlude one and the other and ask to blow some air. Use the most patent, 10. Explain pt: I'm going to clean the bridge of your nose with alcohol to get rid of the oil and ensure the tube stays in place. Allow it to dry. Then put the benzoil tincture on the nose also. Place towel over patients chest. 11. Measure distance to insert the tube from nose, to earlobe to xyphoid process. Place the smallest tape in the final mark. Put the lubricant on a gauze. Lubricate 2-4 in of tube. Use the syringe. Withdraw 20 ml of air and connect it to the tube to be inserted. 12. Alert patient that the procedure will begin. Ask patient to EXTEND NECK BACK AGAINST BED. Insert tube until resistance. When resistance is found ask pt to FLEX HEAD FORWARD. Ask him to drink sips of water/swallow, and keep inserting the tube until the taped mark. Fix the tube with the largest tape to the side of the face. 13. Proceed to check placement of the tube. Use the pen light to make sure the tube is straight down the stomach and not curled in pts throat. Ask pt to open mouth and use tongue depressor. Then confirm placement in stomach. Take 20 ml of air with the syringe in the kit, place sthetoscope over stomach and press the syringe to hear a swishing sound. Also can aspirate 5 ml of stomach fluid and use gastric pH test it with the acid kit strip 14. Use the pant tape. Apply tape to the nose leaving the split end free. Wrap the two split ends of tape around the tube in opposite directions. Turn pts face to the opposite site from where the tube is going to be fasten to the gown and fix it to the gown. Make sure nose tape is really fix to the tube so the tube doesnt come out. 15. Put the spike on the tube and connected to the prefix suction. Keep the dark blue tube in upright position next to the pillow. 16. Put the bed to the lowest position. 17. Ideally document the procedure like: NGT in place, pt tolerate it well.

18. When taking it out. Turn off the suction. Disconnect it. Take off the tapes. Give tissues to the patient. Ask the patient to take a deep breath and hold it.