Chest drains also known as under water sealed drains (UWSD) are inserted to allow draining of the pleural spaces of air, blood or fluid, allowing expansion of the lungs.

1. WATER SEAL DRAINAGE
Presented by:
Mr. Abhay rajpoot

2. DEFINITION:
Nasogastric tube: A tube that is passed through the nose and down
through the nasopharynx and esophagus into the stomach. It can be used
to remove the contents of the stomach, including air, to decompress the
stomach, or to remove small solid objects and fluid, such as poison, from
the stomach.

4. TYPES OF TUBES:
 Short tubes: passed through the nose into the stomach: range in size from
14 to 18 Fr, single lumen made of plastic or rubber with holes near the tip.
 Medium Tubes: tubes are passed through the nose to the duodenum and
the jejunum.
 Long tubes: passed through the nose, through the esophagus and stomach
into the intestines. Used for decompression of the intestines.

5. INDICATIONS FOR GI INTUBATION

6. INSERTION OF AN NG TUBE
Assessment:
− Who needs an NG:
 Surgical clients
 Ventilated client
 Neuromuscular impairment.
 Clients who are unable to maintain adequate oral
intake to meet metabolic demands.

7. CONTI…..
− Assess patency of nares:
Assess client’s medical history:
 Nosebleeds
 Nasal surgery
 Deviated septum
 Anticoagulation therapy –
Assess client’s gag reflex. –
Assess client’s mental status. –
Assess bowel sounds-

8. PLANNING:
Gather equipment:
 14 0r 16 Fr NG tube
 Lubricating jelly
 Flashlight
 Emesis basin
 Catheter tipped syringe
 50 ML syringe
 Bowl with water
 Stethoscope

9. CONTI……
• Explain procedure to client
• Position the client in a sitting or high fowlers position.
• Examine feeding tube for flaws.
• Determine the length of tube to be inserted.
• Measure distance from the tip of the nose to the earlobe
and to the xyphoid process of the sternum.
• Prepare NG tube for insertion.

10. RISKS OF NASOGASTRIC INSERTION
NG tube feeding can also potentially cause:
-Abdominal cramping
-Abdominal swelling
-Diarrhea
-Nausea
-Vomiting
-Regurgitation of food or medicine

11. MEASUREMENT:

12. IMPLEMENTATION−

14. CONTI….Emphasize the need to mouth breathe and swallow during the procedure.
Swallowing facilitates the passage of the tube through the oropharnyx.
 Advance tube each time client swallows until desired length has been
reached.
 Do not force tube.
 Check placement of the tube.
− X-ray confirmation
− Aspiration

15. NG TUBE INSERTION:
NasogastricTube Position:

16. EVALUATION:
Observe client to determine response to procedure.
ALERTS!!! Persistent gagging
–Prolonged intubation and stimulation of the gag
reflex can result in vomiting and aspiration
−Coughing may indicate presence of tube in the
airway.
Note location of external site marking on the tube
 Documentation

17. RESPONSIBILITIES:
 Identify signs and symptoms of inadvertent
respiratory migration.
 Identify conditions that increase the risk for
spontaneous tube dislocation from the intended
position (retching, vomiting, nasotracheal
suctioning, severe coughing) Enteral Nutrition.

18. BIBLIOGRAPHY:
• https://www.healthline.com/health/nasogastric-intubation-and-
feeding#purpose
• https://www.wikihow.com/Insert-a-Nasogastric-(NG)-Tube
• https://www.wikihow.com/Insert-a-Nasogastric-(NG)-Tube
• https://en.wikipedia.org/wiki/Nasogastric_intubation
• https://www.nursingtimes.net/clinical-
archive/gastroenterology/nasogastric-tubes-1-insertion-technique-
and-confirming-position/5000781.article