This document discusses gastrointestinal intubation, including: - Types of gastrointestinal intubation like orogastric, nasogastric, and nasointestinal tubes. - Common uses of gastrointestinal intubation like administering medications, sampling sections for diagnostics, and performing lavage. - Types of tubes used like orogastric, nasogastric, and nasointestinal tubes, some with multiple lumens. - The technique for nasogastric intubation including positioning, measuring tube length, lubricating the tube, and having the patient swallow to advance the tube into the stomach.

1. GASTROINTESTINALINTUBATION
Lokesh Silvester. J
House surgeon S1

2. INTRODUCTION
• Intubation: Placement of tube into
body structure
• Types of intubation
Orogastric: Mouth to stomach
Nasogastric: Nose to stomach
Nasointestinal: Nose to intestine
Ostomy: Surgically created opening

3. GIT INTUBATION USES
•Performing a gavage
•Administering oral medications
•Sampling sections for diagnostics
•Performing a lavage
•Compression/decompression

4. TYPES OFTUBES
•Orogastric tubes
•Nasogastric tubes
Some have more than one lumen
Gastric sump tubes (double-lumens)
•Nasointestinal tubes
Longer than nasogastric tubes
•Transabdominal tubes
Gastrostomy tube
Jeunostomy tube

5. Types of NasogastricTube
• Levin catheter, which is a single
lumen,small bore NG tube. for
administration of medication or nutrition.
• Salem Sump catheter: large bore tube
with double lumen. For aspiration in one
lumen, and venting in the other to reduce
negative pressure and prevent mucosal
adhesion.
• Dobhoff tube, which is a small bore NG
tube with a weight at the end intended to
pull it by gravity during insertion

6. TYPES OFTUBES
NasogastricTube

8. Technique
•Explain procedure to client
•Position the client in
Fowlers position
•Examine feeding tube
•Determine length of tube
to be inserted
•Measure distance from tip
of nose to earlobe and to
xyphoid process of
sternum
•Prepare tube for insertion

9. Implementation
1. Wash Hands
2. Put on clean gloves
3. Lubricate the tube
4. Hand the client a glassof water
5. Gently insert tube through nostril to back of throat. Aim back
and down toward the ear.
6. Have client flex head toward chest after tube haspassed
through nasopharynx

10. 7. Emphasizetheneedtomouthbreatheandswallowduringtheprocedure
8. Swallowingfacilitatesthepassageofthetubethroughtheoropharynx.
9. Whenthetipofthetubereachesthecarniastopand listenfor airexchangefrom
thedistalendofthetube.Ifairisheardremove thetube.
10. Advancetubeeachtime clientswallowsuntildesiredlengthhasbeenreached
11. Donotforcetube.Ifresistanceismet(cough,chokeor becomecyanotic)stop
advancingthetubeandpullback
12. Checkplacementofthetube.
X-rayconfirmation
TestingpHofaspirate
13.Securethetubewithtapeor commercialdevice

12. Evaluation
•Observe client to determine response to procedure
•Persistent gagging can result in vomiting and aspiration
•Coughing may indicate presence oftube in airway
•Note location of external site marking on the tube
•Documentation
size of tube , which nostril and client’s response
Record length of tube from the nostril to end of tube
Record aspirate pH and characteristics

13. Testing placement
•Wash hands and put on clean gloves
•Draw up 30cc of airinto syringe and attach to end of NG tube.
Flush tube with 30cc of airproper to attempting to aspirate fluid.
•Draw back on syringe to obtain 5-10cc of gastric aspirate.
•Observe appearance of aspirate;
•From enteral feeding: Appearance of enteral feed
•Fromnasointestinal: Bile stained
•From stomach (non feed): Green,tan, bloody, brown
•Pleural fluid: Pale yellow and serous

14. Complications
•Clogged tube: Most common
•Dumping Syndrome: solution with high osmolality-
water moves into stomach and intestines from fluid
surrounding the organs and vascular system causing
dehydration, hypotension and tachycardia
•Aspiration: ensure head of bed is elevated at least 30
degrees while feeds are being administered
•Dehydration: diarrhea is common problem
•Electrolyte imbalance: Hyperkalemia and
hypernatremia
•Oral mucosa breakdown
•Nasal irritation

15. THANK YOU