Nasogastric Tubes
Nasogastric Tubes



Avoiding Incorrect NG Placement

  • Oesophageal (i.e. not far enough) - measure the intended insertion length (nose to earlobe to xiphoid process) prior to insertion, and check NG position via pH of aspirate or chest x-ray prior to using the NG.
  • Oropharyngeal - ask the patient to open their mouth and check that the tube has not become looped around in the mouth. This should be suspected if there is excessive gagging.
  • Tracheobronchial - withdraw the NG if the patient starts excessively gagging or coughing.
  • Intracranial - do not insertion an NG tube for patients with suspected base of skull fracture, as you may cannulate the brain.
  • Pleural / Peritoneal (i.e. perforation) - some pressure may be required to advance the tube against mild resistance, but do not keep pushing the tube against significant resistance.
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Metheny NA, Meert KL, Clouse RE. Complications related to feeding tube placement. Current opinion in gastroenterology. 2007 Mar 1;23(2):178-82.
Pancorbo?Hidalgo PL, García?Fernandez FP, Ramírez?Pérez C. Complications associated with enteral nutrition by nasogastric tube in an internal medicine unit. Journal of clinical nursing. 2001 Jul 20;10(4):482-90.
 Pandey AK, Ak S, Diyora BD, Sayal PP, Ingale HA, Radharkrishnan M. Inadvertent insertion of nasogastric tube into the brain. JAPI. 2004 Apr 8;52:322-33. Pillai JB, Vegas A, Brister S. Thoracic complications of nasogastric tube: review of safe practice. Interactive cardiovascular and thoracic surgery. 2005 Oct 1;4(5):429-33.