Component Task: Insertion of Nasogastric Tube

This is a clean procedure whereby a nurse introduces/passes a nasogastric tube through the nostrils, posterior oropharynx, esophagus into the stomach bag.

Aims

·         Aspirate gastric content

·         Feed and administer medications

·         Instill ice cold solution to control gastric bleeding

·         Prevent vomiting and aspiration

·         Decompress the stomach

·         Perform gastric lavage in drug over dosage or poisoning

·         Obtain specimen for diagnostic tests

Requirements

·         Nasogastric tube (appropriate size)

·         Lubricant (water soluble)

·         Cotton wool swabs

·         Examination gloves

·         PH strip/litmus paper/Gallipot containing water/Stethoscope

·         10mls Syringe

·         Marker

·         A glass of water

·         Mackintosh cape with towel

·         Plaster

·         Scissors

·         Cotton tipped applicator

·         Rubber apron

Steps

1.        Establish rapport (refer steps)

2.      Explain procedure to child or caregiver/family (refer steps)

3.      Allow caregiver to take a decision of either staying or leaving the resuscitation area

4.      Assess baseline vital signs of child

5.      Perform hand hygiene, disinfect and set tray

6.      Provide privacy

7.       Put on personal protective equipment

8.      Preform hand hygiene

9.      Don examination gloves

10.    Place child in high Fowler’s position or with the head slightly elevated

11.      Cover the chest area with a mackintosh cape and towel

12.    Examine nostrils to determine best side for insertion

13.    Measure and mark nasogastric tube from tip of nose to ear lobe, then to the end of the xiphoid process of the sternum

14.    Lubricate the tip of the tube and pass via nare posteriorly, beyond pharynx into the esophagus and then into the stomach

15.    Instruct child to swallow and advance tube if child can take instructions

16.    Advance tube until mark is reached

17.    Check for placement of NG tube by using litmus paper to assess the pH level of the aspirated gastric content or with a stethoscope, auscultate air insufflated through the feeding tube (whoosh test)

18.    Secure tube with tape

19.    Observe child for any discomfort or distress

20.  Congratulate child and caregiver/family

21.    Document procedure and findings in nurses note