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Nasogastric tubes (NGT) are flexible tubes made primarily of plastic inserted through the nostrils and advanced through the nasopharyngeal tract and into the upper portion of the small intestine.

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- Provide nutrition to unconscious patients and patients who have difficulty swallowing.
- Prevent esophageal/stomach atrophy in unconscious patients.

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1. Personal protective equipment
2. NG/OG tube
3. Catheter
4. Water-soluble lubricant
5. Bile bag
6. Securing device or tape
7. Cup of water
8. pH indicator paper
8. Anaesthetic throat spray

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Perform hand hygiene and prepare all the necessary supplies for insertion.

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Check doctor’s orders for the type of NG tube to be placed and the reason for placement.

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Check doctor’s orders to determine whether the NG tube is attached to suction or a drainage bag.

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Inspect the condition of the patient’s nasal and oral cavities, carefully noting for the presence of skin breakdown and lesions.

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Assess the patient’s level of consciousness and understanding of the procedure.

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Assess the patency of the nares by asking the patient to sniff and exhale through the nose.

Note: If the patient is unconscious, place a finger a few inches below the nares to feel the air coming out to determine nasal patency.

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Palpate patient’s abdomen for distension, pain, and/or rigidity—Auscultate for bowel sounds.

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Position patient sitting up at 45 to 90 degrees (unless contraindicated by the patient’s condition), with a pillow under the head and shoulders.

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Raise bed to a comfortable working height.

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Agree on a signal the patient can use if they wish you to pause during the procedure.

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Place a towel on the patient’s chest and provide facial tissues and an emesis basin.

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Provide the patient with drinking water and a straw if the patient is not fluid restricted.

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Stand on the patient’s right side if you are right-handed and the left side if you are left-handed.

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Measure distance of the tube from

The tip of the nose, to…

The earlobe, to…

The xiphoid process

and then mark the tube at this point.

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Lubricate NG tube tip according to your agency policy.

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Apply clean non-sterile gloves.

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Curve 10 to 15 cm of the end of the NG tube around your gloved finger, and then release it.

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Have the patient drop head forward and breathe through the mouth.

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Have the patient drop head forward and breathe through the mouth.

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Insert NG tube tip slowly into the patient’s nostril and advance it steadily, in a downward direction, along the bottom of the nasal passage, with the curved end pointing downward in the direction of the ear on the same side as the nostril.

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Insert NG tube tip slowly into the patient’s nostril and advance it steadily, in a downward direction, along the bottom of the nasal passage, with the curved end pointing downward in the direction of the ear on the same side as the nostril.

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Continue to advance the NG tube until you reach the mark/tape you had placed for measurement.

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Verify tube placement according to agency policy.

Color-coded pH paper is usually used, as an initial and interim check, to confirm that acidic contents are present. Then an X-ray is taken to confirm placement prior to using an NG tube for feeding.

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Secure the tube to the patient’s gown with a safety pin, allowing enough tube length for comfortable head movement.

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Document the procedure according to agency policy, and report any unexpected findings to the appropriate health care provider.