Nasogastric Intubation (Training Physician)

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SAMPLE EXCERPT
- Full procedure text, video and illustrations available with the full product
PRE-PROCEDURE
INDICATIONS
  • Decompression of the gastrointestinal tract
  • Administration of oral agents in patients unable to tolerate fluids
  • Some cases of gastrointestinal hemorrhage
  • Some cases of pancreatitis
CONTRAINDICATIONS
  • Substantial maxillofacial trauma
  • Esophageal abnormalities
  • Altered mental status and/or inability to protect the airway
EQUIPMENT
  • Gloves, protective gown, and face shield
  • Nasogastric tube
  • 2% lidocaine jelly
  • Phenylephrine or oxymetazoline nasal spray
  • Atomized lidocaine or benzocaine spray
  • Cup of water with straw
  • Emesis basin
  • Towels or absorbent pads
  • 60-mL catheter tip syringe
  • Stethoscope
  • Tape
  • Suction
ANATOMY
  • The superior, middle, and inferior turbinates extend from the lateral walls of the nasal cavity; these structures are projections of the walls of the maxillary and ethmoid sinuses. A properly inserted nasogastric tube will pass underneath the inferior turbinate.
  • The roof of the nasal cavity comprises the frontonasal, ethmoid, and sphenoid bones. The cribriform plate (a portion of the ethmoid bone) is very thin and, if fractured, may provide a misdirected NGT a portal of entry directly into the cranial cavity.
  • The posterior nasal cavities converge into the choanae, which is the beginning of the pharynx. During swallowing, the larynx raises and the epiglottis bends posteriorly to cover the trachea. This physiology is taken advantage of during the insertion of an NGT.

PROCEDURE
Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

POST-PROCEDURE
CARE
  • Attach the tube to wall suction (< 125 mmHg), on the intermittent setting.
  • Secure a proximal portion of the tube to the patient gown.
COMPLICATIONS
  • Nasal irritation, epistaxis, and sinusitis
  • Esophageal trauma
  • Pneumothorax
  • Aspiration
  • Intracranial trauma
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