- comatose patients
- patients with neck or facial injuries, or recent surgeries
- patients breathing with the assistance of a mechanical ventilator
- premature infants
- abdominal cramping or swelling from feedings that are too large
- nausea and vomiting
- regurgitation of the food or medicine
- aspiration of the food or medicine (food or medicine accidentally making its way into your lungs)
- a tube obstruction or blockage
- a tube perforation or tear
- tubes coming out of place and causing additional complications
Nasogastric (NG) intubation is a procedure during which a thin, plastic tube is inserted through the nostril, down the esophagus, and into the stomach. Once an NG tube is in place, healthcare providers can deliver food and medicine directly to the stomach or remove substances from it.
Nasogastric (NG) intubation is most often used to deliver food and medicine to a patient when they are unable to eat or swallow.
Patients most likely to need an NG tube include:
An NG tube may also be used to remove poisonous substances or deliver medicine to neutralize a potentially dangerous substance. Patients with a suspected drug overdose or accidental poisoning may receive NG tubes so that healthcare providers can reduce the chances of death or severe reaction and deliver treatment more quickly.
In addition, an NG tube may be used to remove contents of the stomach for testing or analysis. The contents of the stomach can tell doctors how well the gastrointestinal tract is functioning. An NG tube can also be used to remove an intestinal obstruction or blockage that may be causing pain, discomfort, and swelling.
NG tubes are usually administered in the hospital. However, some patients may receive NG tubes while at home.
In the hospital, the NG tube is inserted while the patient is lying down. At home, a trained caregiver will do this procedure. The patient is instructed to bend their head, neck, and body at various angles as the tube is pushed through the nostril, down the esophagus, and into the stomach. These movements will help ease the tube into position without causing much pain or discomfort. The patient is sometimes asked to swallow or take small sips of water while the tube is in the esophagus so that the tube can slide more easily. The doctor will reposition the tube if it is causing discomfort or pain.
When the NG tube is in place, a healthcare provider will check the placement by attempting to draw fluid out of the stomach. They might also do this by inserting air through the tube and into the stomach, while listening with a stethoscope, or use an X-ray. The healthcare provider will also secure the NG tube with a piece of tape so you cannot accidentally remove it.
For patients who are unable to eat or drink, NG intubation and feeding is one way to ensure they’re receiving adequate nutrition and medication. Also, NG intubation is a less invasive alternative to surgery in the event an intestinal obstruction can be removed easily without surgery.
If a patient is conscious when the NG tube is inserted, they may feel some discomfort as the tube is passed through the nostril and into the stomach.
If the NG tube is not properly inserted, it can injure the tissue inside the sinuses, throat, esophagus, or stomach. Tubes can also mistakenly be placed into the lungs; food and medicine may pass into the lungs if this were to occur.
NG tube feedings also have some complications. These include:
An NG tube is meant to be used only on a short-term basis. Using a temporary NG tube for too long can lead to sinusitis, infections, and ulcerations on the tissue of your sinuses, throat, esophagus, or stomach. For long-term tube feedings, a doctor may wish to perform minor surgery and insert a gastrostomy tube.
For the most part, patients do not have to prepare for an NG intubation or feeding. Before inserting the tube, a patient may need to blow their nose and take a few sips of water. Once the tube is inserted into the nostril, they may need to swallow or drink water to help ease the NG tube through the esophagus.
Once the NG tube is placed and secured, it is used to deliver food and medicine or remove substances from the stomach. Patients fitted with the NG tube need to maintain good oral health practices (brushing teeth regularly) and cleaning their nose frequently. Healthcare providers will also need to check for signs of irritation, infection, or ulceration while the NG tube is in place. They can be asked to change the tape daily to keep the skin from breaking out or becoming irritated and sensitive.