labskill NGT
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Transcript of labskill NGT
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INDICATIONS
Use of a nasogastric tube is indicatedto:
Decompress the stomach by
aspiration of gastric contents (fluid, air,blood).
Introduce fluids (lavage fluid, tube
feedings, activated charcoal into thestomach.
Assist in the clinical diagnosis through
analysis of substances found in gastric
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An NG is normally put in so thatspecially prepared liquid food can be
put down the tube to feed your child.
The reason your child needs it forfeeding may include:
If your child has problems with their
sucking and swallowing
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If your child is not getting enoughnutrition through their normal diet
If your child cannot swallow the
medications they need Sometimes, an NG may be put in to
empty the stomach contents through
the tube.
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CONTRAINDICATIONS
Nasogastric tubes are contraindicated orused with extreme caution in people withparticular predispositions to injury fromtube placement. These may include:
Patients with sustained head trauma,maxillofacial injury, or anterior fossa skull
fracture. Inserting a NG tube blindlythrough the nose has potential ofpassing through the criboform plate, thuscausing intracranial penetration of the
brain.
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Patients with a history of esophageal
stricture, esophageal varices, alkali
ingestion at risk for esophageal
penetration.
Comatose patients have the potential ofvomiting during a NG insertion procedure,
thus require protection of the airway prior
to placing a NG tube.
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Caution should be utilized when passing a
NG tube in a patient with suspectedcervical spine injury.
Excessive manipulation or movement by
the patient during placement includingcoughing or gagging may potentiate
cervical injury.
Manual stabilization of the head isrequired during the procedure.
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EQUIPMENT REQUIRED
Non-allergenic tape
Protective pad or towel
Rubber Band
Gloves
Curved Basin
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Safety pin Cup of water with straw
Stethoscope
60 cc Irrigating syringe Water soluble lubricant
NG tube (plastic or rubber) of appropriate
size Suction
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PROCEDURE
If possible, explain the procedure to the
patient
Position the patient as follows: If the patient is awake and alert-in a sitting
position in high-Fowlers.
If the patient is obtunded or unconscious-head
down, preferably in a left side lying position.
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Place a protective pad/towel on the
patients chest as well as provide thepatient with a basin to minimize contact
with aspirated gastric contents.
Using the NG tube as a measuring devicedetermine the length of the NG tube to be
passed by measuring the length from
nose to earlobe
earlobe to xiphoid process
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Add the measurements together and mark
this total distance with a small piece of
tape.
Inspect both of the patients nostrils for
patency. Have the patient blow nose if
able.
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Lubricate the first 6 inches of the NGtube liberally with a water soluble
lubricant. Choose the largest patent
nostril and begin to pass the NG tubethrough the nostril to the nasopharynx;
direct the tube through the nostril
aiming down and back.
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Once in the pharynx instruct the patient to
swallow either mimicking the action or bysipping on small amounts of water. If
awake and alert have the patient place
chin to chest to facilitate easier passage of
the tube. Introduce the tube until the
selected mark (indicated by the tape) is
reached.
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Ask the patient to hum or
talk. Coughing, cyanosis or chokingmay indicate that the NG tube has
passed through the larynx.
Place the open end of the NG tubein a cup of water. Persistent
bubbling may indicate that the NG
tube has passed through the larynx.
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If unable to positively confirm that the NGtube has been placed is in the stomach
the tube must be removed immediatelyand re-attempted.
Once confirmed for placement, secure the
NG tube by placing one end of tape onfrom the bridge to the tip of the nose andthe other end wrapped around the tubeitself. If possible the nose should be clean
and prepped prior to securing with tinctureof benzoin.
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