Nasogastric ng feeding tube insertion childrens hospital of. For babies with feeding tube already in situ check for evidence of tube displacement before each feed loose tape, movement of tube marker and test for ph level prior to each feed. Procedure for ng og insertion in newborns slideshare. Check for tube placement by aspirating stomach contents, and by instilling 0. A misplaced ngt compromises patient safety, increasing the risk for serious and even fatal complications.
Pull the tube out of the mouth or nose using a swift, consistent motion. Cirgin ellett ml, cohen md, perkins sm, smith ce, lane ka, austin jk. However, evidence of the best practice for estimating the ng tube insertion length in extremely low birthweight elbw infants is limited. It takes time and practice to learn how to insert the tube, so be patient with yourself. A soft silastic nasogastric ng tube is a long, thin, hollow tube which is passed through a nostril of the nose into the throat and. Ngog tubes may be used for feedings, medication administration, or removal of contents from the stomach via aspiration, suction, or gravity drainage. Nasogastric ng tube insertion is an important skill youll be required to demonstrate in your osce exams. Measure length of the og tube from the tip of the patients nose to the earlobe and then to the xiphisternum.
Note cm markings on tube or mark tube with instrument tape by wrapping a small piece around at premeasured length. Gently insert the tube in a smooth swift motion, advancing slightly down and towards the ear on that side, to the desired length. Flex the newborns chin on his chest to facilitate passage. Confirming the position of a nasogastric orogastric. Openpediatrics is an interactive digital learning platform for. Feeding tube placement is not a procedure without risks. What the ng tube looks like on a child once in place.
Dip the end of the feeding tube into about 3 inches of water. In nasogastric ng intubation, a thin tube is placed through your nose into your stomach. Inserting the tube is usually a short procedure, and the tube will go down easily if your child is relaxed. Placing a gastric tube can be a very stressful event.
Gastric tube use and care in the nicu sciencedirect. Infants and children insertion and confirmation of. Improving the accuracy of indwelling gastric feeding tube placement in the neonatal population. There is potential risk for ngt misplacement with each insertion. Results for nasogastric tube use in neonates 1 10 of 90 sorted by relevance date click export csv or ris to download the entire page or use the checkboxes to select a. If still unsuccessful, discontinue procedure, notify medical. You can use the tube to feed your child if they are unable to take enough food by mouth or they are not safely able to take food by mouth. The tube is inserted into the nose or mouth and slid into the stomach. Position the client in a sitting or high fowlers position. What you need to know before inserting and verifying placement of a nasogastric tube in the adult patient, below, teaching the patient about the procedure and what is expected of himher during the ngt insertion process, measuring the ngt for insertion, inserting the ngt, confirming placement, and monitoring the patient for complications following. If an infant is expected to require long term gastric feeding the parents need to be taught care and insertion techniques prior to discharge.
Action to make sure that the ng tube is in the stomach. Insertion and care of nasoorogastric tube northern devon. If the tube has been insitu already, seek advice from senior neonatal nursing staff. To understand the possible complications and how to avoid that.
The procedure requires excellent procedural and communication skills to perform the task effectively whilst reassuring the patient. There are ways you can help your child to remain calm, including distraction and. Predicting the insertion length for gastric tube placement in neonates. Nasogastric tube placement and verification in children.
A nasogastric nayzogastric tube ngt is a thin, soft tube that is passed through your childs nostril, down the back of their throat, through the oesophagus food pipe and into their stomach. The nurses decisionmaking process during gastric tube procedure begins. Procedures for measuring and verifying gastric tube placement in. As nasogastric tubes are more commonly used in neonates, the term nasogastric will be used throughout this guideline indications to keep stomach deflated or to instil enteral feeds when full oral feeding not possible. This is the first in a twopart unit on nasogastric tube. Nasogastric ng and orogastric og feeding tubes are commonly used in the nicu to provide nutrition, administer medications, and allow for gastric decompression.
Recommended use of nemu to predict the length to insert a ng tube. Pediatric ng tube placementverification video for professionals. The nasal route is the preferred placement for enteral tubes except where contraindicated below. The placement of a nasogastric tube ngt in a pediatric patient is a common practice that is generally perceived as a benign bedside procedure. Procedure for intermittent infant feeding using ogtngt. Learn the proper technique for placement of a nasogastric tube for feeding or air removal. Nasogastric versus orogastric route of feeding in preterm. To facilitate the safe and effective care of an infant, child or young person with an enteral tube nasogastric, orogastric, nasojejunal, orojejunal. A soft silastic nasogastric ng tube is a long, thin, hollow tube which is passed through a nostril of the nose into the throat and down into the stomach. Measure length of tube as for short term gastric tubes. A nasogastric ng tube is a small tube that goes into the stomach through the nose. Nasoorogastric tube management guidelines for the newborn up to 28 days. A weightbased formula for the estimation of gastric tube.
A guide on how to insert your childs nasogastric tube and how to check to make sure the placement inside your child is correct. Swaddle infant to provide comfort with the infant lying supine at a 15 o 40 o angle, insert the tube to the stomach as normal. Nasogastric tube feedings are used for infants and children who are not able to take in enough calories by mouth. Found nemu to be a better predictor than weibly et al. Measure distance from the tip of the nose to the earlobe and to the xyphoid process of the sternum. Aspiration if the tube is placed incorrectly increased risk of gastroesophageal reflux with prolonged use damage to the skin on the face 1. Prior to tube insertion the tube must be lubricated with water. Nicu procedures nasogastric and orogastric tube placement. Pediatric nasogastric tube placement and verification. Feeding tube insertion episode ftie is defined as episode of insertion of og or ng tube. Placing a gastric tube in a term or preterm infant is a multiple step process. Predicting the insertion length for gastric tube placement. Tube feedings are also given to older children who cannot eat by mouth.
The formula is then put into the tube and flows through it into the stomach. Nasogastric ng tubes are used in the neonatal intensive care unit nicu for various indications. If any resistance is felt and this is an initial tube insertion, stop and seek advice from medical staff senior nursing staff. Nasojejunal tube insertion page 4 of 7 62018 measurement for infant nasogastric ng tube is a long, thin, hollow tube which is passed through a nostril of the nose into the throat and down into the stomach.
Nasogastric ng tubes or orogastric og tubes are small tubes placed either through the nose or the mouth and end with the tip in the stomach. Insert the tube into the oral cavity and then direct tube. The tube is allowed to cool in the refrigerator for an hour. Nicu procedures nasogastric and orogastric tube placement nicu trainee portal is an innovative new program to complement your education during your nicu rotation. When restricted to the 124 neonates in whom the ng tube was correctly placed in the stomachpylorusduodenum regions and tube measurements from the lower border of the diaphragm on radiograph along the curve of the tube were available, length of the neonate alone was found to be the best predictor for insertion length of the tube r 2 0. To provide a method of instillingliquids or other substances into thestomach, withdrawing gastric contents,andor assessing esophageal anomalies. Infants and children insertion and confirmation of placement of nasogastric and orogastric tubes summary this guideline represents a best practice guide for the insertion and confirmation of placement of nasogastric and orogastric tubes in children and infants in the acute care setting. Ng tube insertion is a procedure i am very familiar with, mainly in adults, in ed, icu and retrieval.
The injection of air with auscultation is still widely used to assess tube placement in neonates, but is known to be unreliable. This document is only valid for the day on which it is accessed. Insertion and management of nasogastric and orogastric. Learn why this procedure is used and what it involves. Nasogastric ng tube insertion is a routine occurrence in all emergency departments, both adult and paediatric.
Nasogastricorogastric tube insertion, verification, and. A method that determines the minimum insertion length of the tube has been specifically developed for low birth weight newborns 1. Nasogastric ng tube insertion osce guide geeky medics. Orogastric and nasogastric tubes are used for both decompression and feeding in the. Identify the appropriate size orogastric tube for insertion.
92 1193 615 852 266 1447 908 1249 1499 1074 1075 363 380 39 827 490 625 1186 280 198 1057 1349 637 823 404 220 182 929 115 588 1590 26 1600 1608 445 1478 1194 994 1040 571 33