An NG tube is a long, thin polyurethane, silicone, or rubber tube that's inserted into a patient's nasal or oral passage to administer gavage or remove lavage substances in the stomach.
NG tubes come in sizes ranging from 4 French Fr to 18 Fr. For sizes measured in Fr: the smaller the number, the smaller the diameter. The sizes are further broken down by age groups. Neonatal patients typically use 4 to 8 Fr; pediatrics, 6 to 14 Fr, with a length of NG tubes are often used for patients who are comatose or have experienced trauma to their oral pathway. Other indications include:.
The NG tube is typically a temporary solution-usually less than 6 weeks-and may later be removed or replaced by a more permanent apparatus.
NG tube insertion is generally performed by the RN or the physician. After insertion, placement is confirmed by X-ray. If your patient needs extra calories and is unable to eat, the NG tube may also be used for feeding. The specific type of formula is ordered by the physician: modular, polymeric, elemental, and specialized formulas are available. There are formulas that enhance wound healing, others help control blood glucose, some optimize the respiratory system, and still others work with the kidneys.
Elemental formulas don't contain whole proteins; they only have the building blocks of proteins amino acids. If your patient has experienced a major burn, multisystem organ failure, trauma, or an extended illness, a specialized formula may be ordered to provide the adequate high calories and specific proteins needed for healing. Contraindications to NG tube placement are divided into two categories: absolute and relative. Absolute contraindications mean that the procedure may produce a life-threatening situation and should be avoided if possible.
Relative contraindications mean that caution should be used because the possibility of an adverse event is possible; the benefits must outweigh the risks.
Absolute contraindications to NG tube placement are severe midface trauma and recent nasal, throat, or esophageal surgery. Severe midface trauma can easily compromise the patient's airway, and some facial and cranial vault bones are extremely thin and fragile. With midface trauma, you run the risk of the NG tube going through the cribriform plate of the ethmoid bone; if this happens, then the NG tube will be in the cranial vault with fatal results.
NG tubes should only be placed by a surgeon if being used for a patient who's undergone recent nasal, throat, or esophageal surgery. The risk of reopening the suture line is too great and can lead to serious post-op complications. Never replace a post-op NG tube that has inadvertently been removed; notify the surgeon immediately per your facility's policy. Gently insert the NG tube along the floor of the nose, and advance it parallel to the nasal floor ie, directly perpendicular to the patient's head, not angled up into the nose until it reaches the back of the nasopharynx, where resistance will be met cm.
If using Salem sump , the blue pigtail or air vent should be positioned above the level of the stomach to avoid back flow of stomach secretions. An anti-reflux valve is attached to the blue pigtail to prevent gastric contents from seeping out.
Conclusions: That it is safe to remove nasogastric tube early within 24 hours in patients undergoing abdominal surgeries.
Early nasogastric tube removal and early oral feeding thus follows the principle of achieving anatomical and physiological continuity heralding early recovery.
A bright red blood NG tube aspirate or emesis from NVUGIB or a dark venous blood aspirate or emesis from variceal hemorrhage would suggest recent bleeding. If the suction canister for the NG tube continues to fill with either shade of blood , then active bleeding is in progress. An NG tube is a long, thin, bendable plastic or rubber tube with holes at both ends. Depending on the type of NG tube , it may help remove air or excess fluids out of the stomach.
Sometimes, an NG tube is placed to get samples of fluid from the stomach for testing. A gastrointestinal tube feeding tube or enema tube is needed when a child has a condition that prevents normal eating or bowel movements. Some gastrointestinal tubes deliver nutrition directly to the stomach or small intestine while others allow enemas to be placed directly into the large intestine.
Nasogastric tubes are flexible single or double lumen tubes which are commonly used in clinical practice. Traumatic injury to the GI mucosa may occur during NG tube insertion and can result in GI bleed , especially in patients with coagulopathy. Nurses can verify the placement of the tube by performing two of the following methods: ask the patient to hum or talk coughing or choking means the tube is properly placed ; use an irrigation syringe to aspire gastric contents; chest X-ray; lower the open end of the NG tube into a cup of water bubbles indicate.
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. Previous: Gather supplies: nonsterile gloves. Perform safety steps: Perform hand hygiene. Check the room for transmission-based precautions.
Introduce yourself, your role, the purpose of your visit, and an estimate of the time it will take. Confirm patient ID using two patient identifiers e. Explain the process to the patient and ask if they have any questions. Be organized and systematic. Raghav Bansal, Email: gro. Corresponding author. Key Clinical Message Nasogastric NG tube is frequently used in clinical practice for a variety of indications; however, NG tubes are not without risks, and there are a multitude of gastrointestinal complications that are associated with their use.
Keywords: Gastrointestinal bleed, nasogastric tube, salem sump tube. What is the etiology of the upper gastrointestinal GI bleed in our patient? Open in a separate window.
Figure 1. Authorship RB: Endoscopist, manuscript editing and final approval. Conflict of Interest None declared. Reference 1.
0コメント