Implementation Nasogastric Tube (NGT) Insertion
- Washing your hands and adjust equipment
- Explain the procedure in patients
- Help the patient to fowler's position
- Stand on the right patient if you are predominantly right-handed (or left side if you left-handed dominant)
- Check and correct the nasal. Ask the patient to breathe through one nostril while the other hole blocked, repeat on the other nostril, Clear mucus and secretions from the nose with a damp tissue or cotton stick. Check is there any infection etc.
- Place a bath towel over the patient's chest.
- Prepare tissue within reach.
- Use gloves.
- Determine the length of tube to be inserted and marked with tape.
Measure the distance from nostril to ear, by placing the tip of a circular tube in the ear leaf; Continue measuring from the earlobe to the bulge of the sternum; mark the location of the bulge sternum with a small plaster. - Ask the patient tilted head, insert the tube into the nostrils of the most clean.
- When you insertion deeper into the nose hose, ask the patient hold the head and neck straight and opened his mouth.
- When the tubes are visible and the patient can feel the tube in the pharynx, instruct the patient to bend your head forward and swallow.
- Insert the hose deeper into the esophagus by providing gentle pressure without forcing the patient to swallow (if the patient coughs or hoses rolled up in the throat, pull the hose into the pharynx and repeat the steps), among these efforts encourage the patient to breathe in.
- As a sign of plaster on the hose to reach the entrance to the nostrils, stop the insertion of the hose and check placement: ask the patient opened his mouth to see the hose, Aspiration with syringe and monitor drainage of the stomach, pull air into the syringe with 10-20 ml into the hose and push enter air while listening to the stomach with a stethoscope if audible rumble, fixation hose.
- To secure the hose: scissors the center of the plaster along the 2 inch, leaving 1 inch remains intact, attach 1-inch tape on the nose hole, wrap one end, then the other, one side of the tape winding around the hose.
- Plaster hose is curved to one side of the patient's face. These rubber bands can be used to fix the hose.
Note:
Fowler Position: The patient sits upright half (45-60 degrees), the knee may be bent or straight. There are 3 types of positions Fowler:
High Fowler: The head of the patient raised 80-90 degrees
Semi Fowler: The head of the patient raised 30-45 degrees
Low Fowler: appointed Chief of patients <30 degrees