What is the major risk of a nasogastric tube?
Your NG tube can also potentially become blocked, torn, or dislodged. This can lead to additional complications. Using an NG tube for too long can also cause ulcers or infections in your sinuses, throat, esophagus, or stomach. If you need long-term tube feedings, your doctor will likely recommend a gastrostomy tube.
What are the side effects of nasogastric feeding tubes?
What Are the Side Effects of Feeding Tubes?
- Aspiration. One of the most common side effects of feeding tubes is aspiration, notes the Oral Cancer Foundation.
- Irritation. ...
- Organ Puncture. ...
- Misplacement or Migration. ...
- Infection. ...
Can you feed the patient with the nasogastric tube?
Your doctor or nurse can give you food and medicine through an NG tube. They can also apply suction to it, allowing them to remove contents from your stomach. For example, your doctor may use NG...
How to insert a nasogastric (NG) tube?
Steps on Nasogastric Tube Insertion
- Wash the hands thoroughly and dry them before donning sterile gloves. ...
- Explain the procedure to the patient and answer any of their questions before moving forward with the procedure.
- The nurse should now position an unconscious patient in a lying position on the left side of the body, and position a patient who is awake in a sitting position.
Why is a nasogastric tube used?
A nasogastric tube (NG tube) is a special tube that carries food and medicine to the stomach through the nose. It can be used for all feedings or for giving a person extra calories. You'll learn to take good care of the tubing and the skin around the nostrils so that the skin doesn't get irritated.
What conditions require an NG tube?
If you can't eat or swallow, you may need to have a nasogastric tube inserted....NG tube feeding can also potentially cause:abdominal cramping.abdominal swelling.diarrhea.nausea.vomiting.regurgitation of food or medicine.
Which patients benefit from nasogastric tube?
It is used to deliver nutritional support and medications to patients who are unable to swallow or are unable to meet their nutritional requirements by mouth. Nasogastric feeding is commonly encountered in older patients (defined as over 65 years old) owing to dysphagia and malnutrition [1].
How long can an NG tube stay in?
The use of a nasogastric tube is suitable for enteral feeding for up to six weeks. Polyurethane or silicone feeding tubes are unaffected by gastric acid and can therefore remain in the stomach for a longer period than PVC tubes, which can only be used for up to two weeks.
What does an NG tube do for bowel obstruction?
A nasogastric tube (NG tube) is used to drain fluid from the stomach, so that the bowel can rest and return to normal size.
What is the best indication of proper placement of a nasogastric tube in the stomach?
An abdominal radiograph is considered the “gold standard” for determining the position of a nasogastric tube, especially in a critically ill, elderly, dysphagic or unconscious patient.
How painful is an NG tube?
NG tubes are very painful. They are routinely rated as among the very worst things that we do to patients. It is possible to limit the pain associated with NG placement using topical lidocaine, although it is unclear how long the analgesic effect will persist, as these tubes are generally left in place for many days.
How does NG tube help with vomiting?
An NG tube can also remove gastric content, either draining the stomach by gravity or by being connected to a suction pump. In these situations, the NG tube is used to prevent nausea, vomiting, or gastric distension, or to wash the stomach of toxins.
Why is it important to confirm a nasogastric tube?
Why Confirming Placement Of A Nasogastric Tube Is So Important. One of the most uncomfortable experiences for a patient in the hospital is the insertion of a nasogastric (NG) tube. This hollow, flexible tube is inserted through the patient’s nose, past the throat, and into the stomach. The tube inevitably passes over the nerves and muscles ...
How to confirm placement in the stomach and not in the respiratory tract?
The current gold standard for confirming placement in the stomach and not in the respiratory tract is to take an X-ray of the chest and abdomen. Other techniques include:
What is the purpose of esophagus?
Controlling bleeding in the esophagus (the organ that connects your throat to your stomach) Decompressing a buildup of air and gases in the stomach after surgery. Temporarily giving medication or feedings to someone who cannot swallow (e.g. a premature infant, someone who has had a stroke, or a patient in a coma) ...
What causes stomach contents to be removed?
Removal of stomach contents if food is not passing through the intestines because of blockage or loss of peristalsis (the wavelike motion that pushes food through the intestines as it is being digested)
Can NG tubes be misinterpreted?
Research on the prevention and detection of misplaced NG tubes continues to show that all techniques, even X-rays, can be misinterpreted. Some methods are controversial because they can give false assurance that the tube is in the stomach.
Can a tube go down the windpipe?
As the tube is going in, it is possible for it to miss the esophagus and travel instead down the windpipe and into the lungs. This is a potentially fatal mistake, especially if a doctor’s order calls for feedings and medication to be given through the tube.
Why do you need a nasogastric tube?
Less commonly, nasogastric tubes can be placed to administer medications or nutrition in patients who have a functional gastrointestinal tract but are unable to tolerate oral intake. This is most commonly in patients who have suffered a stroke or other malady, which has left them unable to swallow effectively.[3] .
What is the standard nasogastric tube used for?
For decompression, the standard tube used is a double-lumen nasogastric tube. There is a double-one large lumen for suction and one smaller lumen to act as a sump.
What are the complications of nasogastric tubes?
The most common complications related to the placement of nasogastric tubes are discomfort, sinusitis, or epistaxis, all of which typically resolve spontaneously with the removal of the nasogastric tube. As noted previously in the contraindications, nasogastric tubes may cause or worsen a perforation in the setting of esophageal trauma, particularly after caustic ingestion, where extreme caution must be used if the placement is attempted. Blind placement of the tube in patients with injury to the cribriform plate may lead to intracranial placement of the tube.[20] If the tube is being placed for the administration of medications or nutrition, intragastric placement must be confirmed. Introducing medication or tube feeds to the lungs can cause major complications, including death.[2] Even in intubated patients, the NG tube can still be accidentally placed into the airway.[21] Another complication that all those managing nasogastric tubes should be aware of is specifically for the double-lumen nasogastric tubes. These large diameter tubes stent the lower and upper esophageal sphincter open while in place. If the tube becomes obstructed or otherwise malfunctions and is unable to decompress the stomach, it potentially increases the risk of an aspiration event secondary to this stenting effect.[22] Prolonged use of NG tube can cause irritation to the gastric lining, causing gi bleeding.[23] Patients with extensive irrigation with an NG tube can develop electrolyte abnormalities such as hypokalemia.[24] Prolonged pressure on one area of the nare can cause nasal pressure ulcers or necrosis.[25] The tube should be retaped intermittently to prevent this complication.
Why do people use NG tubes?
NG tubes have been used for various reasons in patients with GI bleeding. In the past, NG lavage was thought to help control GI bleeding. However, recent studies have shown that this is not helpful.[7] Another indication for placement of a nasogastric tube is in the setting of massive hematochezia. Given that up to 15% of massive hematochezia is caused by an upper GI bleed, placement of a nasogastric tube, after initiating resuscitation may potentially aid in diagnosis. Of note, an upper GI source of bleeding is only ruled out after aspiration of gastric contents from a nasogastric tube if the fluid is bile tinged. If the fluid is not bile tinged, it is possible that a duodenal ulcer has caused bleeding but also scarred the pylorus causing a gastric outlet obstruction, which prevents the blood from being aspirated from the stomach.[8] However, the placement of an NG tube has not shown to improve patient outcomes in patients with GI bleed. [9]
What is abdominal decompression?
Abdominal decompression: increased efficency by esophageal aspiration utilizing a new nasogastric tube.
Why should a nasogastric tube be connected to a suction bucket?
The nasogastric tube should be connected to the suction tubing and the suction tubing connected to a suction bucket before placement of the tube to minimize the risk of spillage of gastric contents. All supplies should be close at hand to minimize unnecessary movement during the procedure. Technique.
How to place a NG tube?
The individual placing the tube should put on nonsterile gloves and lubricate the tip of the tube. A common error when placing the tube is to direct the tube in an upward direction as it enters the nares; this will cause the tube to push against the top of the sinus cavity and cause increased discomfort. The tip should instead be directed parallel to the floor, directly toward the back of the patient's throat. At this time, the patient can be given the cup of water with a straw in it to sip from to help ease the passage of the tube. The tube should be advanced with firm, constant pressure while the patient is sipping. If there is a great deal of difficulty in passing the tube, a helpful maneuver is to withdraw the tube and attempt again after a short break in the contralateral nares as the tube may have become coiled in the oropharynx or nasal sinus. In intubated patients, the use of reverse Sellick's maneuver (pulling the thyroid cartilage up rather than pushing it down during intubation) and freezing the NG tube may help facilitate placement of the tube.[15] Once the tube has been inserted an appropriate length, typically around 55 cm as previously noted, it should be secured to the patient's nose with tape. [16]
Why do we need a nasogastric tube?
Nasogastric tubes may be placed for prophylactic or therapeutic reasons (that is, to prevent problems from occurring, or to fix problems that already exist). Nasogastric tubes can also be used for diagnostic purposes, since it is possible to collect gastric contents using an NG for laboratory analysis.
What are the complications of a nasogastric tube?
More significant complications include erosion of the tube where the tube is anchored, esophageal perforation, pulmonary aspiration, a collapsed lung, or intracranial placement of the nasogastric tube.
How long does a nasogastric tube last?
Nasogastric tubes are primarily intended for short-term use, typically for 48 – 72 hours. Patients who require feeding or medication administration via an NG tube for longer than 48 – 72 hours should consider getting a percutaneous endoscopic gastrostomy, or PEG tube, which is a tube that goes directly into the stomach.
What is the tube that carries food?
Nasogastric tubes (NG tubes) are flexible plastic tubes, usually polyurethane or silicone, that carry food or medicine through the nose and down into the stomach, or from the stomach out through the nose.
Why do you need NG tubes after gastric surgery?
To remove gastric secretions (drain the stomach) These patients may have gastrointestinal obstructions (for example, due to cancer), or may have NG tubes inserted immediately after major surgery to help keep the stomach empty and prevent post-operative emesis.
How to insert NG tube?
Your first step in inserting an NG tube is to gain informed consent. The patient should be given an explanation of the insertion procedure, and should know why the tube is necessary. Follow your institution’s guidelines for obtaining verbal or written consent, and document what you have done.
What is NG tube?
NG tubes may also be used to aspirate (i.e. drain) the stomach in case of a gastrointestinal (GI) bleed, or in the case of poisoning or a drug overdose. To administer food or medicine to patients who have difficulty swallowing (i.e. dysphagia) or who are unable to swallow. This may include, for example, patients who recently experienced a stroke, ...
How to prepare for nasogastric intubation?
In most cases, you won’t need to take any special steps to prepare. Right before it’s inserted, you may need to blow your nose and take a few sips of water.
What happens if you don't insert a NG tube?
If your NG tube isn’t inserted properly, it can potentially injure the tissue inside your nose, sinuses, throat, esophagus, or stomach. This is why placement of the NG tube is checked and confirmed to be in the correct location before any other action is performed. NG tube feeding can also potentially cause:
What is the procedure called when you can't swallow?
Nasogastric Intubation and Feeding. If you can’t eat or swallow, you may need to have a nasogastric tube inserted. This process is known as nasogastric (NG) intubation. During NG intubation, your doctor or nurse will insert a thin plastic tube through your nostril, down your esophagus, and into your stomach. Once this tube is in place, they can use ...
How does NG intubation work?
During NG intubation, your doctor or nurse will insert a thin plastic tube through your nostril, down your esophagus, and into your stomach. Once this tube is in place, they can use it to give you food and medicine. They can also use it to remove things from your stomach, such as toxic substances or a sample of your stomach contents.
How to lower your risk of complications from NG intubation?
How can you lower your risk of complications? To lower your risk of complications from NG intubation and feeding, your healthcare team will: ensure the tube is always taped securely to your face. check the tube for signs of leakage, blockage, and kinks. elevate your head during feedings and for an hour afterwards .
How to check NG tube placement?
Once your NG tube is in place, your healthcare provider will take steps to check its placement. For example, they might try to draw fluid out of your stomach. Or they might insert air through the tube, while listening to your stomach with a stethoscope.
Why do we need NG intubation?
NG intubation is most commonly used for the following reasons: feeding. delivering medication. removing and evaluating stomach contents. administering radiographic contrast for imaging studies. decompressing blockages. It’s also used to help treat some premature infants.
Why do we need nasogastric tubes?
Nasogastric tubes are indicated for the following reasons: ● Treatment of ileus or bowel obstruction – Gastrointestinal decompression using nasogastric tubes is important for the treatment of patients with bowel obstruction or prolonged ileus.
Where are nasoenteric tubes?
Nasogastric and nasoenteric tubes are flexible double or single lumen tubes that are passed proximally from the nose distally into the stomach or small bowel. Enteric tubes that will be removed within a short period of time can also be passed through the mouth (orogastric). This topic will review the indications, contraindications, placement, ...
