View source for Nasogastric or Orogastric Tube

==Procedure Guidelines==
===9.23 NASOGASTRIC/OROGASTRIC TUBE===

'''''Contact Medical Control for Physician's Orders'''''

====INDICATIONS:====
* Gastric decompression

====CONTRAINDICATIONS:====
* Absolute – Known or suspected esophageal varices
* Relative – Ingestion of caustic poison

====EQUIPMENT:====
* 14, 16 or 18 Fr. Levin tube, (for adults).
* 35 cc syringe.
* Water soluble lubrication gel.
* Tape.
* H2O.
* Saline.

====PRECAUTIONS:====
* It will be difficult and painful to pass tube on a patient with a deviated septum or nasal obstructions.
* In conscious patients, gag reflex will be elicited. If patient gags, pause insertion allowing patient to take breaths or drink a few sips of water.
* Epistaxis is a common complication.
* If tube curls up inside pharynx, withdraw it and re-insert.
* It is possible to inadvertently intubate trachea with NGT.

====PROCEDURE:====
'''''CONTACT MEDICAL CONTROL FOR PHYSICIAN'S ORDERS.'''''
* Mark distance tube should be inserted by measuring from nose to ear lobe to below xyphoid process.
* Lubricate distal 6 - 8" of NGT.
* Examine nose for septal deviation. Use right nares if both nostrils are the same size.
* Place patient in semi-fowler's position, if condition permits and slightly flex head.
* Insert tube in nostril and gently pass tube into nose or thru King Tube.
* Encourage patient to swallow as tube is advanced to pre-determined depth.
* Confirm tube placement by aspirating gastric contents and by auscultating epigastrium while injecting 20 -30 cc air through tube.
* Aspirate stomach contents and irrigate concomitantly, as ordered.
* Tape tube in place and maintain suction if ordered.

[[Category:Procedure Guidelines|0923]]