Why ng tube

It can also be used to give medications, which can be really helpful in some medical situations. An NG tube will be placed by a healthcare professional, such as a physician or a nurse, and it's typically done in the hospital. It might be done while a patient is asleep sedated , but it is often done when the patient is awake.

Local sedation of the nostrils with lidocaine or an anesthetic spray might be used. The NG tube is inserted up through the nostrils and down through the esophagus and into the stomach.

The patient is usually told to swallow while the NG tube is being placed. The procedure is uncomfortable, but it shouldn't be painful that could indicate that the tube is not placed properly. After the tube is in, the healthcare team will check to make sure it's in the right place and everything has gone as it should. One way of doing this is by taking an X-ray, which will show the placement of the tube. Another way is by using the tube to add or remove some stomach contents, which can show that the tube is properly placed in the stomach.

The outside of the tube will be taped down in place on the skin so that it doesn't become dislodged accidentally. NG tubes can be very effective at treating some conditions and in administering medications, but they're not without the potential for some less-than-desirable effects. People with an NG tube might experience some symptoms such as diarrhea, nausea, vomiting, abdominal cramps, or swelling.

While most NG tubes are placed without any incident, there are some risks. One of the things that can happen while the tube is being inserted is an injury to the esophagus, throat, sinuses, or stomach.

It's possible that if an NG tube gets blocked or torn, or if it comes out of place, there can be further problems. There's also a possibility for any food or medicine being put through the tube to be regurgitated or to go into the lungs aspirated. The healthcare professionals who place nasogastric tubes are trained to be on the lookout for any potential complications. Most patients agree that an NG tube is a difficult thing to deal with, and can be uncomfortable, especially when it's being placed.

However, it can help prevent surgery in some cases, such as with an intestinal blockage. It is uncomfortable, but it shouldn't be painful. An NG tube is temporary, so it will be in place only for as long as it's needed, which, in many cases, may be only a few days. For example, your doctor may use NG intubation to help treat accidental poisoning or drug overdose. For instance, they may administer activated charcoal through your NG tube to help absorb the harmful substance.

This can help lower your chances of a severe reaction. An NG tube insertion typically occurs in either a hospital or your home. Before they insert the tube, they will apply some lubrication to it and likely some numbing medication as well. They will likely ask you to bend your head, neck, and body at various angles as they thread the tube through your nostril, down your esophagus, and into your stomach.

These movements can help ease the tube into position with minimal discomfort. They may also ask you to swallow or take small sips of water when the tube reaches your esophagus to help it slide into your stomach.

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. To keep your NG tube in place, your care provider will likely secure it to your face with a piece of tape. They can reposition it if it feels uncomfortable. NG intubation can also help your doctor treat an intestinal obstruction in ways that are less invasive than intestinal surgery.

Non-essential equipment that is helpful to have is a cup of water with a straw in it for the patient to sip from during the procedure, provided they can tolerate it. This swallowing action helps advance the tube, and the water can ease some of the irritation on the back of the oropharynx from the tube.

The topical use of local anesthetic such as lidocaine has not been shown to be very useful. While an experienced provider can place a tube by themselves, having an assistant nearby can be helpful in case extra supplies need to be obtained during the placement procedure, such as a basin if the patient begins to have emesis.

The indication for the procedure, potential complications, and alternative to treatment should be explained to the patient and an informed consent form signed. The patient should be placed in the sitting position if possible.

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. 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. Once the tube has been advanced to the estimated necessary length correct location is often made obvious by aspirating out a large amount of gastric contents.

Pushing 50 cc of air through the tube using a large syringe while auscultating the stomach with a stethoscope is a commonly described maneuver to determine the location of the tube, but it is of questionable efficacy. Taking an abdominal x-ray is the best way to confirm the location of the tube, even if there is the aspiration of gastric contents as the tube may be placed past the pylorus where it will aspirate not just gastric secretions but also hepatobiliary secretions leading to persistently high output even when the patient's acute issue has resolved.

If feeding is planned through the tube, then it is imperative to confirm its location as placing feeds into the lungs can cause potentially fatal complications. The ideal location for NG tube placed for suction is within the stomach because placement past the pylorus can cause damage to the duodenum. The ideal location for an NG feeding tube is postpyloric to decrease the risk of aspiration. The removal of an NG tube is usually a simple procedure. However, the tube should not be forcefully removed as it can become knotted.

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.

Introducing medication or tube feeds to the lungs can cause major complications, including death. 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.

Whether decompressing the stomach, providing enteral access for nutrition and medications in a patient unable to tolerate them orally, or ruling out an upper GI source of bleeding in the setting of massive hematochezia; nasogastric tubes are part of the standard of care for many routine health issues. Physicians should be readily able to place nasogastric tubes if indicated, and nursing staff should be able to manage them effectively.

Given the potential for major complications to occur, particularly if medications or tube feeds are given intrapulmonary, with inappropriate nasogastric tube placement, the entire healthcare team must know the indications, contraindications, possible complications, and appropriate work-up to confirm placement.

As mentioned above, while it is helpful to have at least one assistant nearby when placing a nasogastric tube, an experienced healthcare provider can generally place one by her or himself without much difficulty. Where interprofessional care comes into play with nasogastric tubes is in maintaining them. Physicians should check that the nasogastric tube is functioning and not clogged or otherwise malfunctioning when they round.

Nursing staff should also routinely inspect their patients' nasogastric tubes to ensure they are functioning and have a high index of suspicion for potential aspiration events.

Frequent examinations by all healthcare providers to ensure the tube is securely in place and properly positioned can also reduce injuries associated with nasogastric tubes. Nasogastric tube tip encircled. Aayush Dhakal". This book is distributed under the terms of the Creative Commons Attribution 4.

Turn recording back on. National Center for Biotechnology Information , U. StatPearls [Internet]. Search term. Nasogastric Tube David F. Author Information Authors David F. Tube feeding is often done with a nasogastric NG tube. It sends liquid food directly to the stomach. Liquid food given through the NG tube is digested the same as food eaten normally. The NG tube may look uncomfortable.

But it should not be uncomfortable for your child. An NG tube is only meant to be used for a short time. If your healthcare provider feels your child may need a more long-term solution, there are other kinds of tubes. These can be put directly into the stomach or part of the small intestine with a small surgery.

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