NG Tube Insertion and Care
Auburn Community Hospital Policy
Insertion
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Assess for contraindications
Types of tubes
 Feeding tube
 Salem sump
Patient Education
 Explain procedures and feelings
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Communicate expectations
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Procedure
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Place in high fowlers position
Measure tubing
Prepare NG tube
Insert into nasopharynx
Instruct patient to swallow while inserting tube
Secure tubing to patient’s nose and gown
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Checking Placement
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Observe for coughing and gagging during placement
Fill syringe with air and infuse while listening to the epigastric region
Listen for swishing sound
May aspirate gastric contents
X-RAY may be ordered
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Caring For a Patient with an NG Tube
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Oral care is extremely important
Moisturize lips
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Secure tubing and suction
Monitor bowel sounds and NG drainage
 NG drainage colors may be pale to yellowish green
 Bloody drainage may occur
 Old blood may appear very dark and coffee ground-like
 Fresh bleeding or post-op blood will be bright red
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Medication Administration via NG Tube
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MD order must specify the NG route
Verify placement
Must be liquid or crushable medications
Irrigate with normal saline
Clamp for 30 minutes post medication administration
Enteric coated, sustained release, and oily medications cannot be given through the
NG tube
Evidence Based Practice: Checking Placement
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Sonogram 95% accuracy
Magnetic detection 100% accuracy
Visualization of gastric aspirate 50% accuracy
Auscultation 84% accuracy
pH testing 56% accuracy
Radiographic imaging 100% accuracy
This supports that the most accurate way to verify placement of an
NG tube is by X-RAY
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X-RAY View of NG Placement
Tube Irrigation
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Keep head of bed up 30-45 degrees
Irrigate only if tube is occluded
Use only normal saline for flushing
Do not place meds or fluid through air vent
Documentation
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Size of tube
Verification of tube placement
Color of NG secretions
Condition of the skin on the nose and in the nasal passages
How patient is tolerating the NG tube
Review of NG Procedure
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A chest x-ray is the most accurate way to verify NG placement post insertion
For routine evaluation every shift, two or more checks should be done to verify
placement including: auscultation, visualization of gastric contents, and checking
pH level
Call pharmacy with any medication questions
The best method for medication administration via the NG tube is to give one med
at a time with a 10-15ml flush after. Evidence shows that this will decrease the
interactions between medications which will decrease the risk for adverse reactions
References:
CliniSnips (Producer). (2008, July 16). Nasogastric tube insertion [video clip]. Retrieved
from YouTube: http://www.youtube.com/watch?v=en5ct21InOyA
Joanna Briggs Institute (2010). Methods for determining the correct nasogastric tube
placement after insertion in adults. Best Practices, 14(1), 1-4. Retrieved for http://
connect.jbiconnectplus.org/ViewSourceFile.aspx?0=5384
Lewis, S. L., Dirksen S. R., Heitkemper, M. M., Bucher, L., Camera, I. M. (2011). MedialSurgical Nursing: Assessment and Management of Clinical Problems (8th ed.).
St. Louis, MO: Elsevier.
NC/R&P Committee (2010). Nasogastric Tubes Insertion, Care and Maintenance.
Auburn Community Hospital Policies and Procedures. Policy No. P-250.