Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword by Professor Lord Ara Darzi KBE
- Preface
- Section 1 Perioperative care
- Section 2 Surgical emergencies
- Section 3 Surgical disease
- Section 4 Surgical oncology
- Section 5 Practical procedures, investigations and operations
- Urethral catheterization
- Percutaneous suprapubic catheterization
- Vascular access
- Arterial cannulation
- Central line insertion
- Lumbar puncture
- Airway
- Chest drain insertion
- Thoracocentesis
- Pericardiocentesis
- Nasogastric tubes
- Abdominal paracentesis
- Diagnostic peritoneal lavage (DPL)
- Rigid sigmoidoscopy
- Proctoscopy
- Oesophago-gastro-duodenoscopy (OGD)
- Endoscopic retrograde cholangio-pancreatography (ERCP)
- Colonoscopy and flexible sigmoidoscopy
- Local anaesthesia
- Regional nerve blocks
- Sutures
- Bowel anastomoses
- Skin grafts and flaps
- Principles of laparoscopy
- Section 6 Radiology
- Section 7 Clinical examination
- Appendices
- Index
Nasogastric tubes
Published online by Cambridge University Press: 06 July 2010
- Frontmatter
- Contents
- List of contributors
- Foreword by Professor Lord Ara Darzi KBE
- Preface
- Section 1 Perioperative care
- Section 2 Surgical emergencies
- Section 3 Surgical disease
- Section 4 Surgical oncology
- Section 5 Practical procedures, investigations and operations
- Urethral catheterization
- Percutaneous suprapubic catheterization
- Vascular access
- Arterial cannulation
- Central line insertion
- Lumbar puncture
- Airway
- Chest drain insertion
- Thoracocentesis
- Pericardiocentesis
- Nasogastric tubes
- Abdominal paracentesis
- Diagnostic peritoneal lavage (DPL)
- Rigid sigmoidoscopy
- Proctoscopy
- Oesophago-gastro-duodenoscopy (OGD)
- Endoscopic retrograde cholangio-pancreatography (ERCP)
- Colonoscopy and flexible sigmoidoscopy
- Local anaesthesia
- Regional nerve blocks
- Sutures
- Bowel anastomoses
- Skin grafts and flaps
- Principles of laparoscopy
- Section 6 Radiology
- Section 7 Clinical examination
- Appendices
- Index
Summary
A nasogastric (NG) tube provides a conduit into the gastrointestinal (GI) tract (Figure 140).
Indications
▪ Drainage of the GI tract.
▪ Feeding the GI tract, thereby bypassing the oesophageal sphincters.
▪ Sampling contents of upper GI tract.
Contraindications
▪ Base of skull fracture – if suspected a nasogastric tube is contraindicated because it may pass through a fractured cribriform plate to enter the brain. An orogastric tube is the conduit of choice in this instance.
▪ Patients with an unsecured airway – here a nasogastric tube may induce vomiting and lead to aspiration of gastric contents.
▪ Facial fractures.
Types
▪ Ryles tube – wide bore, used for short-term feeding or aspiration of gastric contents.
▪ Fine-bore feeding tube – not for aspiration of gastric contents as its thin soft rubber walls have a tendency to collapse with minimal suction.
Insertion technique
Equipment required:
▪ Universal protection equipment
▪ Nasogastric tube (see above)
▪ Lubricant (KY jelly/2% lidocaine gel)
▪ Adhesive tape
▪ Drainage bag
▪ A 50 ml bladder suction syringe
▪ Glass of water
▪ Bowl for gastric contents
▪ Stethoscope
▪ Litmus paper.
Procedure:
Explain procedure and gain consent (verbal or written) from patient.
Sit patient upright.
Measure the distance from nostril to trans-pyloric plane (midpoint of line from sternal notch to symphisis pubis) and mark on tubing.
Lubricate the end of the tube.
If patient has an intact swallowing reflex, ask him/her to hold a sip of water in their mouth until instructed to swallow.
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- Information
- Hospital SurgeryFoundations in Surgical Practice, pp. 633 - 636Publisher: Cambridge University PressPrint publication year: 2009