While the majority of patents will be able to meet their nutritional requirements orally, there is a group of individuals who will require enteral feeding either in the short term or on a permanent basis

1. PRESENTED BY:
MR MUSTAPHA MBYE
OPERATIONS MANAGER-EFSTH
RN, CM, Msc. NURSING
9/24/2023
Prepared by Mr Mustapha Mbye
1
INSERTION OF A NASO-GASTRIC
TUBE

2. PRESENTATION OUTLINE
9/24/2023
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Definition of terms used in the skills of NG tube
insertion
State types of and reason for special or modified
diets
Identify indication for enteral intubation
Demonstrate the steps used in the skills of NG tube
insertion
Return demonstration

3. Introduction
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 While the majority of patents will be able to meet their
nutritional requirements orally, there is a group of
individuals who will require enteral feeding either in
the short term or on a permanent basis.
 Nasogastric insertion refers to the process of placing a
soft plastic tube through a patient's nostril, past the
pharynx and down the esophagus into a patient's
stomach.

4. 9/24/2023
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 NG tube placement is meant to be a short-term
solution for feeding problems.
 Patients that require long term tube feeding should
have surgical placement of a gastrostomy tube

5. Types of enteral feeding
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 Nasogastric /nasoduodenal
 Gastrostomy
 Jejunostomy

6. Indications for NG tube insertion
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 Unconscious patients
 Dysphagia e.g. cancer of the oesophagus
 Operation involving the mouth, neck, face and the
abdomen
 Client too weak to swallow e.g. premature babies
 Patients on mechanical ventilation
 Removal of substances from the stomach or as a
means of testing stomach function or contents.
 Air removal-CPR

7. Types of tubes
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 Polyurethane
 Silicone
 Polyvinyl chloride (PVC)

8. Types of Modified Diet
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• Clear Liquid
• Full Liquid
• Soft Diet
• Diet as Tolerated (DAT)

9. Clear Liquid Diet
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 This type of diet provides the client with fluid and
carbohydrates in the form of sugar but does nit
supply adequate protein, fats, vitamins, minerals or
calories. It is a short term diet (24-36 hrs). E.g.
Water tea, coffee, carbonated beverages, clear juices
etc.
 The main objective is to relieve thirst, prevent
dehydration and minimize stimulation of the GIT

10. Full Liquid Diet
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 This contains only liquids or foods that turn to
liquid at body temperature, such as ice cream.
 It is often eaten by clients who have gastroinstenal
disturbances or are otherwise unable to tolerate solid
or semisolid foods. E.g. yogurt, vegetable juice,
pudding etc

11. Soft Diet
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 The soft diet is easily chewed and digested. It is often
ordered for clients who have difficulty chewing and
swallowing.
 It is a low residue (low-fiber) diet containing very
few uncooked foods. E.g. meat, mashed potato,
fruits, desserts

12. Reason for a modified diet
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 To promote healing in clients with gastrointestinal
distress.
 Before and after surgery

13. Equipment/Instrument
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 Antimicrobial swab
 NG tube-fine bore tubes vs. wide bore
 Tongue blade
 Flash light
 Lubricant e.g. KY Jelly
 Pen to mark tube
 Adhesive plaster
 Irrigating syringe (50ml) with catheter tip

14. Equipment/Instrument (continued)
9/24/2023
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 pH indicator strip
 Normal saline for flushing
 Stethoscope
 Towel
 Gloves
 Rubbish bag
 Cup and water

15. Preparation
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 Check order and client care plan for inserting an NG
tube
 Identify patient
 Determine size of tube, length of time & client size
 Check tube for defects and flush with water to
confirm patency
 Explain procedure and purpose to client
 Provide privacy
 Gather equipment

16. Procedure
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 Wash hands
 Position the patient in bed with the head of the bed
elevated 45 degrees or higher
 Examine nostril and select the most patent one
 Place a towel over clients chest
 Measure from tip of nose to ear lobe to xiphoid
process of sternum to determine appropriate length
for tube insertion.

17. Procedure (Continued
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 Lubricate tip of tube with water soluble lubricant
 Insert tube through nostril to back of throat. Aim the
tube towards back of throat and down. Suggest client
to swallow
 Continue advancing tube until mark is reached
 Attach syringe to free end of NG tube to check
position of tube
 Inject 10-15 ml of air through NG and listen with the
stethoscope over stomach for a rush of air or
“whoosh”

18. Procedure (Continued)
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 Aspirate gastric content with 50mls syringe and
check for pH
 Tape tube securely to nose
 Secure tube with tape/rubber band pinned to client
gown or bed linen leaving some degree of slack for
head movement
 Provide oral and nasal hygiene
 Position client for comfort
 Observe for any discomfort, cough or distress

19. Procedure (Continued)
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 Wash, rinse and dry equipment
 Return equipment
 Remove gloves and wash hands
 Health educate client on the care of the tube
 Thank patient
 Document and report accordingly E.g. slate date for
removal

20. Confirmation of the tube
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 Auscultate “whoosh” of injected air
 Check colour and pH of aspirate (PH 1-4)
 Abdominal X-ray

21. Complications
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 Aspiration of the stomach contents leading to
asphyxia, abscess formation or aspiration
pneumonia
 Tissue trauma e.g. nasal bleeding

22. 9/24/2023
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THANK YOU VERY MUCH FOR
KIND ATTENTION