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on: NASOGASTRIC
TUBES, PUMPS AND SUMP PUMPS
| Nasogastric
Tube Insertion |
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1. To
reduce gagging, prepare the posterior pharynx and the
base of the tongue with an appropriate topical anesthetic.
Lubricate the nasal cavity with aqueous lubricating jelly. This is
best done by squirting jelly directly through the external naris.
For models with stylet: Do not remove the plastic stylet from the
tube. Check the tip of the tube and make sure the stylet extends
all the way down |
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2. Pass the
tube through the lubricated nasal cavity into the posterior
pharynx until resistance is encountered. If the patient
is conscious, ask the patient to hold his breath and
swallow. Advance the tube gently as the larynx rises
in swallowing. In the unconscious patient, rotate the
tube 180 degrees and advance it gently until the 60cm
positioning mark reaches the external naris.
For “extra stiff” models and models with stylet: The
tube must be inserted only by an experienced and skilled practitioner.
Extra care must be taken to prevent pharyngeal or esophageal perforation. |
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3. WARNING:
If the patient begins to cough violently, withdraw
the tube to the level of the pharynx and proceed with
step 2 again.
In the average adult, pass the tube so that the 60cm mark is at the
external naris. Tape the tube to the nose. |
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4. Place a stethoscope
over the cardia of the stomach and inject air down
the tube.
Bubbling synchronous with the injection will confirm proper placement
of the aspirating tip in the cardia.
For pediatric size models: The tube has four marks: 20, 30, 40 and
50 cm from the most proximal aspirating ports to permit more accurate
placement in infants and children. It should be passed so that the
aspirating tip of the tube is placed in the cardia of the stomach,
not the corpus or the fundus. Tape the tube to the child’s
nose.
For models with stylet: Grasp the stylet with one hand and the tube
at the nose with the other. Remove the stylet. If you must reposition
the tube, remove it completely and reinsert the stylet under direct
vision. Do not try to reinsert the stylet with the tube still in
the patient. |
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5. Connect the
large tube to a low constant vacuum source (the Sump
Pump®
Cat. Nos. AN40 or AN42 are specially designed for use with this tube).
When working properly, the Andersen Nasogastric Tube should be constantly
bubbling. |
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6. If the tube
is not bubbling, first check the vacuum source to see
that it is functioning. If aspirator is functioning,
inject the vent tube (small adapter) through the yellow
filter with 10 cc of air from an ordinary Luer taper
hypodermic syringe. If bubbling does not start immediately,
irrigate the aspirating tube (large adapter) in the
usual manner. If the tube still does not bubble when
connected to suction, remove and replace it. |
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