How can you confirm placement of the nasogastric tube?
In patients with malnutrition or people unable to consume enough nutrition a tube is used for parenteral feeding. It is called a nasogastric tube. Under aseptic conditions tube is measured from firstly from nose to ear lobes and then measured to the xiphisternum. This marks the length of tube needed to be inserted according to every patient. After application of a local anesthetic in the nasal opening and on the tip of the NG tube, it is advanced into the patent nasal opening. The patient is provided with a glass of water and advised to sip it slowly. This opens the esophagus facilitating tube passage. After the measured length is reached the tube is checked for being in the stomach and secured by bandage. The confirmation is done by checking for pH of the aspired contents. If the pH is 0-5 it is in the stomach. If there is no aspiration fluid to check for or there is history of PPI intake an x-ray is performed to confirm the tube location.
You can use one of the following: ALWAYS OPEN THE MOUTH TO FIRST CONFIRM ITS NOT COILED IN THE MOUTH. Then; 1: put the outside end of the tube in water, if it's submerged and it bubbles, means it's in the lungs, if not, then in the stomach. 2: Try aspirating after you have inserted the tube. If you see gastric contents, means you're in the stomach. Mostly will be mixed with food contents 3: Auscultate the abdomen with a stethoscope while an assistant is pumping little air into the tube with a syringe, you will hear the sound of the air exiting the fenestrations in the tube if it's in the stomach. If it's in the lungs you won't. 4: A semiconscious patient will cough a lot even after inserting the tube when it's in the lungs. 5: Use a laryngoscope to see if it's in the esophagus or airway. 6: etc... So many
