231:. The tube is then marked at this level to ensure that the tube has been inserted far enough into the patient's stomach. Many commercially available stomach and duodenal tubes have several standard depth markings, for example 46 cm (18 in), 56 cm (22 in), 66 cm (26 in) and 76 cm (30 in) from distal end; infant feeding tubes often come with 1 cm depth markings. The end of a plastic tube is lubricated (local anesthetic, such as 2% xylocaine gel, may be used; in addition, nasal vasoconstrictor and/or anesthetic spray may be applied before the insertion) and inserted into one of the patient's anterior nares. Treatment with 2.0 mg of IV midazolam greatly reduces patient stress. The tube should be directed straight towards the back of the patient as it moves through the nasal cavity and down into the throat. When the tube enters the
244:
Otolaryngology, is performed by a physician to pull a material through the nares and then tied with the ends shortened to prevent removal of the tube. The other method is a device called the
Applied Medical Technology, or AMT, bridle. This device uses a magnet inserted into both nares that connects at the nasal septum and then pulled through to one side and tied. This technology allows nurses to safely apply bridles. Several studies have proven the use of a nasal bridle prevents the loss of the NG placement that provides necessary nutrients or suctioning. A study conducted in the UK from 2014 through 2017, determined that 50% of feeding tubes secured with tape were lost inadvertently. The use of bridle securement decreased the percentage of NGs lost from 53% to 9%.
29:
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240:, it is easily inserted down into the stomach. The tube must then be secured in place to prevent it from moving. There are several ways to secure an NG placement. One method and the least invasive is tape. Tape is positioned and wrapped around the NG tube onto the patients nose to prevent dislodgement.
288:
to confirm the correct placement of the NG tube. As enzyme testing becomes more practical, allowing measurements to be taken quickly and cheaply at the bedside, this technique may be used in combination with pH testing as an effective, less harmful replacement of X-ray confirmation. If the tube is to
275:
of the chest/abdomen. This is the most reliable means of ensuring proper placement of an NG tube. The use of a chest x-ray to confirm position is the expected standard in the UK, with Dr/ physician review and confirmation. Future techniques may include measuring the concentration of enzymes such as
134:
If the tube is to be used for continuous drainage, it is usually appended to a collector bag placed below the level of the patient's stomach; gravity empties the stomach's contents. It can also be appended to a suction system, however this method is often restricted to emergency situations, as the
110:
into the tube. For continuous feeding, a gravity based system is employed, with the solution placed higher than the patient's stomach. If accrued supervision is required for the feeding, the tube is often connected to an electronic pump which can control and measure the patient's intake and signal
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Function of an NG tube properly placed and used for suction is maintained by flushing. This may be done by flushing small amounts of saline and air using a syringe or by flushing larger amounts of saline or water, and air, and then assessing for the air to circulate through one lumen of the tube,
497:
Mulholland, Michael W., Lillemoe, Keith D., Doherty, Gerard M., Upchurch, Gilbert R., Alam, Hasan B., Pawlik, Timothy M. eds. Greenfield's
Surgery: Scientific Principles and Practice. 6th Edition. Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103:Lippincott Williams & Wilkins;
338:
Complications with nasogastric intubation can occur due to incorrect initial placement of the nasogastric tube or due to changes in tube position that go unrecognized. Nasogastric tubes mistakenly placed in the trachea or lungs can lead to aspiration of enteral feeds or medications administered
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and glides down the posterior pharyngeal wall, the patient may gag; in this situation the patient, if awake and alert, is asked to mimic swallowing or is given some water to sip through a straw, and the tube continues to be inserted as the patient swallows. Once the tube is past the pharynx and
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any interruption in the feeding. Nasogastric tubes may also be used as an aid in the treatment of life-threatening eating disorders, especially if the patient is not compliant with eating. In such cases, a nasogastric tube may be inserted by force for feeding against the patient's will under
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Another securement device is a nasal bridle, or a device that enters one nare, around the nasal septum, and then to the other nare where it is secured in place around the nasogastric tube. There are two ways a bridle is put into place. One method, according to the
Australian Journal of
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or less in adults) nasogastric tubes are appropriate for long-term feeding, so as to avoid irritation and erosion of the nasal mucosa. These tubes often have guidewires to facilitate insertion. If feeding is required for a longer period of time, other options, such as placement of a
200:- These tubes tend to be thicker and can be difficult to place without proper lubrication. Latex tends to break down at faster rates compared to other materials. Allergies to latex are relatively common and latex tubes are more likely to be recognized as a foreign object by the body.
166:, which is a single lumen, small bore NG tube. It is more appropriate for administration of medication or nutrition. This type of catheter tends to be more prone to suctioning against the stomach lining, which can cause damage and interfere with future function of the tube.
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in patients with moderate-to-severe neck and facial fractures due to the increased risk of airway obstruction or improper tube placement. Special attention is necessary during insertion under these circumstances in order to avoid undue trauma to the
329:
Alternative measures, such as an orogastric intubation, should be considered under these circumstances, or if the patient will be incapable of meeting their nutritional and caloric needs for an extended time period (usually >24 hours).
178:, which is a small bore NG tube with a weight at the end intended to pull it by gravity during insertion. The name "Dobhoff" refers to its inventors, surgeons Dr. Robert Dobbie and Dr. James Hoffmeister, who invented the tube in 1975.
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constant suction can easily damage the stomach's lining. In non-emergency situations, intermittent suction is often applied giving the benefits of suction without the untoward effects of damage to the stomach lining.
118:
Nasogastric aspiration (suction) is the process of draining the stomach's contents via the tube. Nasogastric aspiration is mainly used to remove gastrointestinal secretions and swallowed air in patients with
172:, which is a large bore NG tube with double lumen. This avails for aspiration in one lumen, and venting in the other to reduce negative pressure and prevent gastric mucosa from being drawn into the catheter.
142:
in order to prevent anesthesia-related vomiting and possible aspiration of any stomach contents. Such aspiration would represent a serious risk of complications to patients recovering from this surgery.
206:- Especially useful in patients with known latex allergies. Silicone tubes tend to be thinner and more pliable. This can be useful in some situations but can also be more prone to rupture under stress.
271:) to determine the acidity of the fluid. If the pH is 4 or below then the tube is in the correct position. If this is not possible then correct verification of tube position is obtained with an
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to drain. Nasogastric tubes can also be mistakenly placed within the intracranial space; this is more likely to occur in patient who already have specific types of skull fractures.
598:
Manning, Chelsea Taylor; Buinewicz, Jacob Dillon; Sewatsky, Thomas
Patrick; Zgonis, Evangelia; Gutierrez, Kathy; O'Keefe, Michael F.; Freeman, Kalev; Bird, Steven B. (July 2016).
322:. There is also a greater risk to patients with bleeding disorders, particularly those resulting from the distended sub-mucosal veins in the lower third of the esophagus known as
996:
194:- This material is most common. It is less likely to kink, which can be beneficial for placement, but its rigidity makes it less suitable to be used for long term feeding.
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Before an NG tube is inserted, it must be measured from the tip of the patient's nose, loop around their ear and then down to roughly 3–5 cm (1–2 in) below the
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818:"A breath of fresh air: a quality-improvement study comparing an air-circulating technique versus conventional technique to prevent nasogastric tube dysfunction"
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reported about a voluntary field correction notice dated March 21, 2022, referenced 60 injuries and 23 deaths related to misplacement of a nasogastric tube.
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Betsy H. Allbee; Lisa
Marcucci; Jeannie S. Garber; Monty Gross; Sheila Lambert; Ricky J. McCraw; Anthony D. Slonim; Teresa A. Slonim (28 March 2012).
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Motta, Ana Paula Gobbo; Rigobello, Mayara
Carvalho Godinho; Silveira, Renata Cristina de Campos Pereira; Gimenes, Fernanda Raphael Escobar (2021).
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600:"Does Routine Midazolam Administration Prior to Nasogastric Tube Insertion in the Emergency Department Decrease Patients' Pain? (A Pilot Study)"
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Other complications include clogged or nonfunctional tubes, premature removal of the tube, erosion of the nasal mucosa, esophageal perforation
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445:"Nursing assistants' experiences of administering manual restraint for compulsory nasogastric feeding of young persons with anorexia nervosa"
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Perry, AG; Potter, PA (2010). "Skill 34-4: Inserting and maintaining a nasogastric tube for gastric decompression". In
Ostendorf, W (ed.).
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A man with a nasogastric feeding tube through which feed and medicine can be delivered to the stomach using either a pump or gravity
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into the stomach, and out the other lumen. When these two techniques of flushing were compared, the latter was more effective.
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Polyurethane NG tube (Viasys Corflo), 8 Fr Ă— 36 in (91 cm). This fine bore tube is appropriate for longer use (up to 4 weeks).
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644:"A systematic review of the effectiveness and complications of using nasal bridles to secure nasoenteral feeding tubes"
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954:"Avanos Medical Recalls Cortrak*2 Enteral Access System for Risk of Misplaced Enteral Tubes Could Cause Patient Harm"
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Nasogastric tubes are available in a variety of different materials, each with their own unique properties.
123:. Nasogastric aspiration can also be used in poisoning situations when a potentially toxic liquid has been
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which may be easily ruptured due to their friability and also in GERD(Gastro
Esophageal Reflux Disease).
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remain in place then a tube position check is recommended before each feed and at least once per day.
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419:"Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition"
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Taylor, Stephen J; Allan, Kaylee; Clemente, Rowan; Marsh, Aidan; Toher, Deirdre (2018-10-04).
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A nasogastric tube is used for feeding and administering drugs and other oral agents such as
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Lynch, Angelica; Tang, Cheryl S.; Jeganathan, Luxmana S.; Rockey, Jason G. (2018-01-30).
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Bani Hani, Murad; Ihim, Ikenna; Harps, Joyce; Cunningham, Steven C. (27 November 2015).
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Such a practice may be highly distressing for both patients and healthcare staff.
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Great care must be taken to ensure that the tube has not passed through the
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Roberts, James R.; Custalow, Catherine B.; Thomsen, Todd W., eds. (2019).
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680:"Feeding tube securement in critical illness: implications for safety"
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259:. The reliable method is to aspirate some fluid from the tube with a
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Thomas, Bruce; Cummin, David; Falcone, Robert E. (24 October 1996).
569:, Ensure Appropriate Position of the Dubhoff Tube Prior To Feeding.
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780:. Cincinnati Children's Hospital Medical Center. August 22, 2011.
778:"Confirmation of Nasogastric/Orogastric Tube (NGT/OGT) Placement"
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Suction drainage is also used for patients who have undergone a
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is a similar process involving the insertion of a plastic tube (
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is a medical process involving the insertion of a plastic tube (
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Feeding tube going into the stomach through the nose and throat
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Roberts and Hedges' clinical procedures in emergency medicine
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and nasogastric tube as seen on CXR. Both in good position.
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Kodua, Michael; Mackenzie, Jay-Marie; Smyth, Nina (2020).
131:, and to extract samples of gastric liquid for analysis.
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invented the NG tube. Nasogastric tube is also known as
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795:(7th ed.). Mosby Elsevier. pp. 914–920.
738:"Accidental Pneumothorax from a Nasogastric Tube"
380:, has been classified as a Class I recall by the
449:International Journal of Mental Health Nursing
1630:Transjugular intrahepatic portosystemic shunt
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531:(Seventh ed.). Philadelphia: Elsevier.
339:through the NG tube. This can also lead to
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1436:Transanal hemorrhoidal dearterialization
793:Clinical Nursing Skills & Techniques
66:, down the esophagus, and down into the
1593:Artificial extracorporeal liver support
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127:, for preparation before surgery under
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313:The use of nasogastric intubation is
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159:Types of nasogastric tubes include:
1197:Percutaneous endoscopic gastrostomy
1005:Tests and procedures involving the
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1635:Distal splenorenal shunt procedure
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263:. This fluid is then tested with
86:in Commonwealth countries, after
1426:Lateral internal sphincterotomy
927:Aitken, Peter (29 April 2022).
742:New England Journal of Medicine
1133:Endoscopic sleeve gastroplasty
1084:Functional Lumen Imaging Probe
574:Avoiding Common Nursing Errors
1:
1515:Lower gastrointestinal series
1259:Upper gastrointestinal series
699:10.12968/bjon.2018.27.18.1036
121:gastrointestinal obstructions
1781:Diagnostic peritoneal lavage
1500:Double-contrast barium enema
1327:Partial ileal bypass surgery
1204:Esophagogastric dissociation
1598:Bioartificial liver devices
1525:Transrectal ultrasonography
888:10.1590/1518-8345.3355.3400
755:10.1056/NEJM199610243351717
604:Academic Emergency Medicine
384:, following these reports.
366:, sore throat and gagging.
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1520:Small-bowel follow-through
1388:Abdominoperineal resection
1247:Esophagogastroduodenoscopy
687:British Journal of Nursing
292:Only smaller diameter (12
1880:Clinical prediction rules
1786:Intraperitoneal injection
1490:Abdominal ultrasonography
1398:Total mesorectal excision
1317:Intestine transplantation
1107:Sengstaken–Blakemore tube
1089:High resolution manometry
1079:Esophageal motility study
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835:10.1186/s12912-015-0111-9
347:, which often requires a
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26:
1735:Pancreas transplantation
1393:Lower anterior resection
1074:Esophageal pH monitoring
1016:Digestive system surgery
301:, should be considered.
1829:Inguinal hernia surgery
1745:Pancreaticoduodenectomy
1128:Adjustable gastric band
1069:Impedance–pH monitoring
661:10.21037/ajo.2018.01.01
1859:Exploratory laparotomy
1674:Hepatoportoenterostomy
1138:Gastric bypass surgery
1007:human digestive system
224:
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52:Nasogastric intubation
22:Nasogastric intubation
1834:Femoral hernia repair
1620:Liver transplantation
1214:Nissen fundoplication
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78:) through the mouth.
72:Orogastric intubation
1431:Rubber band ligation
1370:Hartmann's operation
1806:Peritoneal dialysis
1625:Portal hypertension
1530:Virtual colonoscopy
1505:Endoanal ultrasound
1421:Anorectal manometry
1416:Anal sphincterotomy
1360:Colonic polypectomy
1155:Collis gastroplasty
421:. NICE. August 2017
378:Cortrak2 EAS recall
170:Salem Sump catheter
80:Abraham Louis Levin
1944:Medical treatments
1300:Jejunoileal bypass
1143:Sleeve gastrectomy
617:10.1111/acem.12961
324:esophageal varices
255:and down into the
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1123:Bariatric surgery
802:978-0-323-06805-5
748:(17): 1325–1326.
693:(18): 1036–1041.
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538:978-0-323-35478-3
461:10.1111/inm.12758
356:esophageal reflux
309:Contraindications
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1094:
1092:
1091:
1086:
1081:
1076:
1071:
1066:
1061:
1059:Heller myotomy
1056:
1050:
1048:
1035:
1033:Upper GI tract
1026:
1020:
1019:
1014:
1011:
1010:
1004:
1002:
1001:
994:
987:
979:
971:
970:
945:
919:
859:
808:
801:
783:
769:
728:
667:
631:
610:(7): 766–771.
590:
583:
559:
544:
537:
500:
490:
432:
409:
408:
406:
403:
402:
401:
396:
389:
386:
374:Avanos Medical
335:
332:
310:
307:
212:
209:
208:
207:
201:
195:
184:
181:
180:
179:
173:
167:
164:Levin catheter
148:
145:
95:
92:
62:) through the
47:
46:
39:
36:
35:
32:
24:
23:
15:
13:
10:
9:
6:
4:
3:
2:
1956:
1945:
1942:
1940:
1937:
1935:
1932:
1931:
1929:
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1911:
1909:
1906:
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1857:
1856:
1855:
1852:
1851:
1849:
1845:
1835:
1832:
1830:
1827:
1825:
1824:Hernia repair
1822:
1821:
1819:
1817:
1813:
1807:
1804:
1802:
1799:
1797:
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1792:
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1591:
1590:
1588:
1586:
1582:
1579:
1577:
1573:
1559:
1556:
1554:
1553:Fecal pH test
1551:
1549:
1546:
1545:
1543:
1541:
1537:
1531:
1528:
1526:
1523:
1521:
1518:
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1508:
1506:
1503:
1501:
1498:
1496:
1493:
1491:
1488:
1487:
1484:
1483:Sigmoidoscopy
1481:
1479:
1476:
1474:
1471:
1469:
1466:
1464:
1461:
1459:
1455:
1452:
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1248:
1245:
1244:
1243:
1240:
1239:
1237:
1235:
1231:
1225:
1222:
1220:
1219:Pyloromyotomy
1217:
1215:
1212:
1210:
1207:
1205:
1202:
1198:
1195:
1194:
1193:
1190:
1188:
1185:
1183:
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1144:
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1136:
1134:
1131:
1129:
1126:
1125:
1124:
1121:
1119:
1116:
1114:
1111:
1108:
1105:
1104:
1102:
1100:
1096:
1090:
1087:
1085:
1082:
1080:
1077:
1075:
1072:
1070:
1067:
1065:
1062:
1060:
1057:
1055:
1054:Esophagectomy
1052:
1051:
1049:
1047:
1043:
1039:
1036:
1034:
1030:
1027:
1025:
1021:
1017:
1012:
1008:
1000:
995:
993:
988:
986:
981:
980:
977:
959:
955:
949:
946:
934:
930:
923:
920:
915:
911:
906:
901:
897:
893:
889:
885:
881:
877:
873:
866:
864:
860:
855:
851:
846:
841:
836:
831:
827:
823:
819:
812:
809:
804:
798:
794:
787:
784:
779:
773:
770:
765:
761:
756:
751:
747:
743:
739:
732:
729:
724:
720:
716:
712:
708:
704:
700:
696:
692:
688:
681:
674:
672:
668:
662:
657:
653:
649:
645:
638:
636:
632:
627:
623:
618:
613:
609:
605:
601:
594:
591:
586:
580:
576:
575:
568:
563:
560:
556:
551:
549:
545:
540:
534:
530:
523:
521:
519:
517:
515:
513:
511:
509:
507:
505:
501:
494:
491:
486:
482:
478:
474:
470:
466:
462:
458:
454:
450:
446:
439:
437:
433:
420:
414:
411:
404:
400:
397:
395:
394:Force feeding
392:
391:
387:
385:
383:
379:
375:
371:
367:
365:
361:
357:
352:
350:
346:
342:
334:Complications
333:
331:
327:
325:
321:
316:
308:
306:
302:
300:
295:
290:
287:
283:
279:
274:
270:
266:
262:
258:
254:
250:
245:
241:
239:
234:
230:
222:
217:
210:
205:
202:
199:
196:
193:
192:Polypropylene
190:
189:
188:
182:
177:
174:
171:
168:
165:
162:
161:
160:
153:
146:
144:
141:
140:pneumonectomy
136:
132:
130:
126:
122:
116:
114:
109:
105:
101:
93:
91:
89:
85:
81:
77:
73:
69:
65:
61:
57:
53:
43:
30:
25:
20:
1801:Paracentesis
1615:Liver biopsy
1510:Enteroclysis
1495:Defecography
1350:Appendectomy
961:. Retrieved
957:
948:
936:. Retrieved
932:
922:
879:
875:
825:
821:
811:
792:
786:
772:
745:
741:
731:
690:
686:
651:
647:
607:
603:
593:
573:
562:
528:
493:
452:
448:
423:. Retrieved
413:
399:Feeding tube
377:
368:
353:
341:pneumothorax
337:
328:
312:
303:
291:
269:litmus paper
246:
242:
226:
203:
197:
191:
186:
176:Dobhoff tube
175:
169:
163:
158:
137:
133:
117:
106:is used for
97:
83:
75:
71:
59:
55:
51:
50:
1791:Laparoscopy
1647:Gallbladder
1610:Hepatectomy
1540:Stool tests
1478:Proctoscopy
1473:Enteroscopy
1458:Colonoscopy
1342:Large bowel
1322:Jejunostomy
1282:Small bowel
1209:Hill repair
1192:Gastrostomy
1170:Billroth II
1160:Gastrectomy
1064:Sialography
963:28 November
938:28 November
933:foxnews.com
822:BMC Nursing
360:nose bleeds
236:enters the
84:Ryle's tube
1928:Categories
1854:Laparotomy
1796:Omentopexy
1773:Peritoneum
1408:Anal canal
1187:Gastropexy
1165:Billroth I
567:Section 82
425:30 January
405:References
349:chest tube
267:(note not
233:oropharynx
129:anesthesia
113:restraint.
1651:bile duct
1576:Accessory
1454:Endoscopy
1365:Colostomy
1355:Colectomy
1312:Ileostomy
1242:Endoscopy
1175:Roux-en-Y
1046:Esophagus
896:1518-8345
882:: e3400.
828:(1): 63.
707:0966-0461
485:220046454
469:1447-0349
364:sinusitis
320:esophagus
286:bilirubin
251:into the
238:esophagus
211:Technique
183:Materials
108:injection
1722:Pancreas
1463:Anoscopy
914:33439952
854:26617465
723:52917586
715:30281347
654:(1): 8.
626:26990304
477:32578949
388:See also
299:PEG tube
265:pH paper
204:Silicone
125:ingested
1099:Stomach
958:fda.gov
905:7798396
845:4661948
764:8992337
278:trypsin
261:syringe
257:bronchi
253:trachea
104:syringe
68:stomach
60:NG tube
1816:Hernia
1380:Rectum
912:
902:
894:
852:
842:
799:
762:
721:
713:
705:
624:
581:
535:
483:
475:
467:
284:, and
282:pepsin
249:larynx
1898:UKELD
1847:Other
1585:Liver
719:S2CID
683:(PDF)
498:2017.
481:S2CID
273:X-ray
198:Latex
147:Types
40:[
1893:PELD
1888:MELD
1695:MRCP
1669:ERCP
965:2022
940:2022
910:PMID
892:ISSN
850:PMID
797:ISBN
760:PMID
711:PMID
703:ISSN
622:PMID
579:ISBN
533:ISBN
473:PMID
465:ISSN
427:2018
94:Uses
64:nose
1700:PTC
1042:SGs
900:PMC
884:doi
840:PMC
830:doi
750:doi
746:335
695:doi
656:doi
612:doi
457:doi
382:FDA
376:'s
343:or
219:An
58:or
1930::
1868:/
1690:IV
1683::
1649:,
1456::
1044:/
956:.
931:.
908:.
898:.
890:.
880:29
878:.
874:.
862:^
848:.
838:.
826:14
824:.
820:.
758:.
744:.
740:.
717:.
709:.
701:.
691:27
689:.
685:.
670:^
650:.
646:.
634:^
620:.
608:23
606:.
602:.
547:^
503:^
479:.
471:.
463:.
453:29
451:.
447:.
435:^
362:,
358:,
294:Fr
280:,
90:.
70:.
1109:)
998:e
991:t
984:v
967:.
942:.
916:.
886::
856:.
832::
805:.
766:.
752::
725:.
697::
664:.
658::
652:1
628:.
614::
587:.
541:.
487:.
459::
429:.
44:]
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