A nasogastric tube or NG tube is a device which is inserted through a nostril and ends up in the stomach. The device expects to function in different capacities in different patients. Most often, the necessity to put an NG tube is for feeding purposes in patients with impaired swallowing abilities as in the case of stroke victims. But, in certain other instances, the indication might be the decompression of the stomach in suspected cases of intestinal obstruction or following surgery. Apart from these two uses, NG tubes function in many different capacities and in certain instances; these tubes are expected to be present for a relatively longer duration.
In such instances, a caregiver or a health care personal needs to know how to maintain these tubes and more importantly how to assess its position as well as when to remove the tube to prevent further complications.
Therefore, following are few guidelines that needs to be followed when handling patients with an NG tube.
Frequently observe any lengthening of the outside part of the NG tube which may suggest the tube might have been dislodged from the stomach. By making a mark at the proximal most part to the nostril at the time of insertion, would help to keep track of the required distance. Lookout for symptoms such as repeated coughing and gagging as these might be indicative of irritation of the throat or the pharynx. This may necessitate pulling the tube out as it will be dangerous to feed through the tube in such instances. If the NG tube is used as a drain, the drain should be emptied as it fills up and at the time of emptying, the tube should be clamped. It should also be remembered that the amount of fluid that is emptied as well as its characteristics have to be recorded for future reference. Always observe loosening at the site of fixation. If the tape which was used in fixing the NG tube in place has got loosened, holding the tube closer to the nose and re-taping it in place would be necessary to prevent dislodging. It would be always good practice to identify if the NG is in place before giving a feed. Thus, listening to the stomach area using a stethoscope while a small amount of fluid or air being injected through the NG tube would alleviate fears of dislodge and thus facilitate safe feeding. Never transport a patient with a NG tube which is attached to a suction device. The suction device should be removed and re-attached once the destination has been reached. Keep the distal end of the NG tube clean and hygienic as it has the potential to introduce infections at any time.
Make sure the patients with NG tubes remains to have good oral hygiene as this in imperative in order to prevent infections, ulcerations and fissuring or else fungal infections.
