Passing a nasogastric tube
To pass a nasogastric tube:
- sit the patient up
- measuring the distance required from the nose to the epigastrium using a 16 to 20 gauge tube
- lubricate the end of the tube
- give the patient some ice to suck
- put the tube into the patient's nose
- gently pass it back, asking the patient to swallow
- push the tube the measured distance, aspirate back and test the secretions with pH paper - it should be acid.
- rapidly inject 20 ml of air down the tube whilst listening over the stomach for a gurgling sound
If the procedure fails a smaller diameter tube can be used. Alternatively a larger bore tube, or a tube kept in a fridge may give the extra rigidity required for passage. Having confirmed that the tube is in the stomach, it is secured in place with tape.
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