NG intubation involves inserting a thin plastic tube through the nose and down into the stomach. It is used to deliver food and medications when someone cannot eat or swallow normally. Some reasons for NG intubation include feeding, giving medications or removing stomach contents. The procedure involves lubricating and inserting the tube while the patient is positioned for ease of insertion. Placement is checked before use to ensure it reaches the stomach safely. Risks include damage if placed incorrectly and complications from long term use such as infections. With proper care and monitoring, NG intubation can help provide nutrition and treatment.

1. NASOGASTRIC INTUBATION
AND FEEDING

2. If you can’t eat or swallow, you may need to have a nasogastric
tube inserted. This process is known as nasogastric (NG) intubation.
During NG intubation, your doctor or nurse will insert a thin plastic
tube through your nostril, down your esophagus, and into your
stomach.
Once this tube is in place, they can use it to give you food and
medicine. They can also use it to remove things from your stomach,
such as toxic substances or a sample of your stomach contents.

3. When would you need nasogastric intubation?
NG intubation is most commonly used for the following reasons:
•feeding
•delivering medication
•removing and evaluating stomach contents
•administering radiographic contrast for imaging studies
•decompressing blockages
It’s also used to help treat some premature infants.
Your doctor or nurse can give you food and medicine through an NG tube.
They can also apply suction to it, allowing them to remove contents from your
stomach.
For example, your doctor may use NG intubation to help treat accidental
poisoning or drug overdose. If you’ve swallowed something harmful, they can
use an NG tube to remove it from your stomach, or to deliver treatments.

4. 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.
Your doctor or nurse can also use an NG tube to:
•remove a sample of your stomach contents for analysis
•remove some of your stomach contents to the relieve the pressure on an
intestinal obstruction or blockage
•remove blood from your stomach
How should you prepare for nasogastric intubation?
An NG tube insertion typically occurs in either a hospital or your home. In
most cases, you won’t need to take any special steps to prepare.
Right before it’s inserted, you may need to blow your nose and take a few
sips of water.

5. What will the procedure involve?
Your healthcare provider will insert your NG tube while you’re
lying down in a bed with the head elevated or sitting in a chair.
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.

6. 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.

7. What are the benefits of nasogastric intubation?
If you can’t eat or drink, NG intubation and feeding can help
you get the nutrition and medications you need. NG intubation
can also help your doctor treat an intestinal obstruction in ways
that are less invasive than intestinal surgery.
They can also use it to collect a sample of your stomach
contents for analysis, which can help them diagnose certain
conditions.

8. What are the risks of nasogastric intubation?
If your NG tube isn’t inserted properly, it can potentially injure the
tissue inside your nose, sinuses, throat, esophagus, or stomach.
This is why placement of the NG tube is checked and confirmed to be in
the correct location before any other action is performed.
NG tube feeding can also potentially cause:
•abdominal cramping
•abdominal swelling
•diarrhea
•nausea
•vomiting
•regurgitation of food or medicine

9. Your NG tube can also potentially become blocked, torn, or dislodged.
This can lead to additional complications. Using an NG tube for too long
can also cause ulcers or infections in your sinuses, throat, esophagus, or
stomach.
If you need long-term tube feedings, your doctor will likely recommend
a gastrostomy tube. They can surgically implant a gastrostomy tube in
your abdomen to allow food to be introduced directly into your stomach.

10. How can you lower your risk of complications?
To lower your risk of complications from NG intubation and feeding, your
healthcare team will:
•ensure the tube is always taped securely to your face
•check the tube for signs of leakage, blockage, and kinks
•elevate your head during feedings and for an hour afterwards
•watch for signs of irritation, ulceration, and infection
•keep your nose and mouth clean
•monitor your hydration and nutrition status regularly
•check electrolyte levels through regular blood tests
•make sure drainage bag is regularly emptied, if applicable
Ask your healthcare provider for more information about your specific
treatment plan and outlook.

11. Feeding Tube for Infants
What is a feeding tube?
A feeding tube, also known as a gavage tube, is used to give nutrition to
infants who cannot eat on their own. The feeding tube is normally used in a
hospital, but it can be used at home to feed infants. The tube can also be
used to give medication to an infant.
The feeding tube can be inserted and then removed for each feeding. Or it
can be an indwelling feeding tube, which means it remains in the infant for
multiple feedings. The feeding tube can be used to give both breast milk and
formula.

12. When does an infant need a feeding tube?
A feeding tube is used for infants who do not have the
strength or muscle coordination to breastfeed or drink
from a bottle. There are other reasons why an infant
might need a feeding tube, including:
•lack of weight gain or irregular weight gain patterns
•absence or weak sucking ability or swallowing reflex
•abdominal or gastrointestinal defects
•respiratory distress
•problems with electrolyte imbalances or elimination

13. What happens during insertion?
During the procedure, your nurse will measure the length from your baby’s
nose or mouth to their stomach. Your nurse will then mark the tube so it is
just the right length for your infant. Then, they will lubricate the tip with
sterile water or water based lubricating gel. Next, they will insert the tube
very carefully into your infant’s mouth or nose. Occasionally doctors will insert
the tube, but it is generally a procedure done by the bedside nurse.
After it is placed, your nurse will check the tube for correct placement by
inserting a small amount of air into the tube and listening for the contents to
enter the stomach. This indicates the tube has been placed correctly. The
most accurate way to test that the tube is in the correct place, without
getting an X-ray, is to withdraw some of the liquid from your baby’s stomach
and test the pH with a simple testing strip. This will ensure that the tube
passed into the stomach and not the lungs.

14. When the tube is inserted, it is taped to the nose or mouth so it stays in
place. If your infant has sensitive skin or a skin condition, your doctor may
use a pectin barrier, or paste, to make sure the skin doesn’t tear when the
tape is removed. There are also devices that secure the tube internally by
using cloth tape that passes behind the nasal bone. To confirm proper
placement, your doctor may order an X-ray of your child’s abdomen to
ensure that the tube is in the stomach.
After the tube is firmly in place, the infant is given formula, breast milk, or
medicine by injection with a syringe or through an infusion pump. You can
hold your baby while the liquid moves slowly through the feeding tube.
After the feeding is complete, your doctor will either cap off the tube or
remove it. You should make sure your infant remains upright or inclined to
prevent the feeding from being regurgitated.

15. Are there any risks?
There are very few risks associated with feeding tube use.
However, it can be uncomfortable for the infant, no matter how
gently it is inserted. If your child begins to cry or show signs of
discomfort, try using a pacifier with sucrose (sugar) to provide
relief.
Other side effects include:
•slight nasal bleeding
•nasal congestion
•nasal infection

16. If you are feeding your baby through a feeding tube at home, it’s
important to watch for signs of tube misplacement. Feeding through
an incorrectly placed tube can lead to breathing difficulties,
pneumonia, and cardiac or respiratory arrest. Sometimes the tube is
inserted incorrectly or accidentally becomes dislodged. The following
signs might mean there is something wrong with where the tube is
placed:
•slower heart rate
•slow or troubled breathing
•vomiting
•coughing
•blue tinge around mouth

17. What is the outlook?
It can be difficult to cope with feeding your infant through a
feeding tube. It is normal to feel a sense of anxiety about not
breastfeeding or bottle-feeding your infant. Many babies only
need to use feeding tubes until they become strong enough or
well enough to feed on their own. Talk to your doctor about the
emotions you’re feeling. If you are feeling sad, your doctor can
help you find support groups and can even evaluate you for
signs of postpartum depression.