NGT placement

NG Tube Placement Steps:

Materials needed:

• • Dobhoff/NG tube

  • Syringe (60mL)

  • Lubricant

• 1. Obtain appropriate NG/Dobhoff, including appropriate size

  2. Measure length required to insert by measuring the distance from:

     1. The tip of the nose, to…

     2. The earlobe, to…

     3. The xiphoid process

     4. Mark this number-this is how far you will insert it.

  3. Lubricate NG

  4. Curve 10 to 15 cm of the end of the NG tube around your gloved finger, and then release it. This will help the tip of the tube conform to the nasopharynx shape. 

  5. Insert NG tube (if patient awake, can ask them to swallow or have them drink water through a straw)

• • 1. If patient not awake and this is done in the OR, can place fingers in the hypopharynx to ensure that the tube does not coil up. 

• 6. Secure to nostril either by suturing or with tape 

• • 1. When suturing to septum, go through the membranous septum, not the columella. Use Addison’s with teeth to pull the columella forward and to fully visualize the membranous septum. 

• 7. When finished, plug/close off both ends of the Dobhoff to ensure that it is not used before placement is confirmed. 

  8. Confirm placement with:

• • 1. Initially: Insufflate stomach and auscultate at Left Upper Quadrant of abdomen

    2. Leave Guidewire in, and obtain Chest X-ray. When X-ray confirms placement in stomach, can remove guidewire. 

• 9. Do not put in order to use NGT before placement is confirmed with X-ray. 

Helpful sources:

http://www.uphs.upenn.edu/surgery/Education/trauma/SCC/Protocols/NG_Feeding_Tube.pdf

https://opentextbc.ca/clinicalskills/chapter/10-2-nasogastric-tubes/

https://www.youtube.com/watch?v=1OakmxZDa5c

https://www.youtube.com/watch?v=dj45W_LZbyE