NASOGASTRIC(NG) TUBE – INSERTION AND CARE

(eg. Salem Sump)

The Salem Sump NG Tube: a double lumen with an air vent, (blue pigtail) which allows atmospheric air to enter the patient’s stomach so that the tube can float freely, thus preventing NGtube from adhering to and damaging the gastric mucosa.

The LARGE PORT is the main suction/aspiration tube.

POLICY (Liverpool Hospital):

EQUIPMENT:

  • Dressing pack.
  • Tube of appropriate size.
  • 50ml syringe with appropriate tips.
  • Leukoplast.
  • Drainage bag if required.
  • Glass of water.
  • Lubricant.
  • Gloves.
  • pH sticks.
  • Stethoscope.

PROCEDURE:

  • Explain procedure to the patient and explain that you will ask them to swallow several times during insertion.
  • Position patient sitting well up in bed with head tilted forward (if not contraindicated).
  • Read instructions on selected tube’s packaging.
  • Wash hands, don gloves
  • Measure distance from a) the lobe of the ear to tip of the nose and from b) the lobe of the ear to the xiphisternum. Note total length on the tube markings.
  • Lubricate tube.
  • Freezing the tube may assist insertion.
  • Gently insert tube along floor of the nose in a backward downward direction for the length a) above.
  • Encourage the patient to facilitate the tube passage, by swallowing. If permitted, sips of water will assist in swallowing.
  • Continue to insert tube to the predetermined distance. (a+b)
  • Test aspirate with litmus paper to establish acidity of stomach contents, listen over stomach with a stethoscope after inserting a bubble of air.
  • Secure tube to nose as per diagram.
  • Give clear instructions written and verbal about suction, aspiration and recording of observations

POST PROCEDURAL CARE:

(Nursing instructions from Nursing Policy Document This has been included, so you know what may be expected of you)

  • Connect to low suction or drainage bag as ordered by RMO.
  • Aspirate as per medical officer’s orders.
  • Document amount, colour, and odour of aspirate 4/24.
  • Observe universal body fluid precaution when aspirating.
  • Never aspirate via blue air inlet of Salem Sump. Clear air inlet of any fluid by injection 10mls of air into blue air inlet especially if difficulty encountered when aspirating, 10mls of air can be injected down the blue air inlet.
  • If aspirate exceeds intake, notify RMO.
  • Replace nasal tapes daily and PRN when soiled or lifting.

SECURING A NASOGASTRIC TUBE:

 (Diagram to be scanned)                

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