Mastering NG Tube Insertion: Essential Nursing Skills

 Video guide

Mastering NG Tube Insertion: Essential Nursing Skills

Nasogastric (NG) tube insertion is a critical skill for nurses, used for feeding, medication administration, and gastric decompression. Proper technique ensures patient safety and comfort.

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1. Understanding NG Tube Insertion

What is an NG Tube?

A nasogastric tube is a flexible tube inserted through the nose into the stomach for:
✔️ Nutritional support (feeding)
✔️ Medication administration
✔️ Removal of stomach contents (decompression)

Types of NG Tubes

• Levin Tube: Single-lumen, used for feeding and suctioning.
• Salem Sump Tube: Double-lumen, designed for continuous suction with an air vent.

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2. Preparation Before Insertion

Gather Equipment:

🔹 NG tube (appropriate size)
🔹 Water-soluble lubricant
🔹 60 mL syringe
🔹 Glass of water with a straw
🔹 pH test strips (to confirm placement)
🔹 Adhesive tape
🔹 Stethoscope
🔹 Gloves and PPE

Patient Preparation:

✅ Explain the procedure to reduce anxiety.
✅ Position the patient in high Fowler’s position (90° sitting up).
✅ Assess nasal patency by asking the patient to breathe through each nostril.
✅ Measure tube length from nose to ear to xiphoid process and mark it.

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3. Step-by-Step NG Tube Insertion

1️⃣ Hand Hygiene & PPE: Wash hands and wear gloves.
2️⃣ Lubricate Tube: Apply water-soluble lubricant to the tip.
3️⃣ Insert the Tube:

• Tilt the patient’s head slightly forward.
• Gently insert the tube into the nostril and advance it toward the ear.
• As it reaches the back of the throat, ask the patient to swallow water while advancing the tube.
• Continue insertion until the marked length is reached.
  4️⃣ Verify Placement:
  ✅ Aspirate Gastric Contents: Check pH (should be ≤5).
  ✅ Auscultate Air Bolus: Inject 20–30 mL of air and listen over the stomach for a "whooshing" sound.
  ✅ X-ray Confirmation: Gold standard for final placement verification.
  5️⃣ Secure the Tube: Tape the tube to the nose and attach it to the designated feeding or suction setup.

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4. Post-Insertion Care

✔️ Monitor for discomfort, nausea, or signs of misplacement.
✔️ Flush with sterile water to prevent clogging.
✔️ Change dressings and assess for skin irritation.
✔️ Document procedure, patient response, and verification method.

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5. Complications & Prevention

🚨 Aspiration → Keep head elevated 30–45° during feeding.
🚨 Nasal or throat irritation → Use proper lubrication and secure the tube well.
🚨 Tube misplacement → Always verify placement before use.

Mastering NG tube insertion ensures safe and effective patient care.