How to Insert a Nasogastric Tube

This video from Children’s Hospital of Philadelphia (CHOP) demonstrates how patients with inflammatory bowel disease (IBD) can insert a nasogastric tube. Topics include gathering supplies, preparing the tube, checking the tube, and using the tube.

Transcript

How to insert a nasogastric tube

Female: This video offers help and guidance for inserting a nasogastric NG feeding tube. Do not try to insert an NG tube until your doctor has decided you can, and you have been taught the right way to insert the tube by a healthcare professional.

Von: Hi, my name is Von and I'm here to show you how to insert an NG tube, which goes up your nose, down your food pipe, and into your stomach.

Female: The first step is to gather your supplies.

Von: You'll need a safe, clean area and the following supplies.

Female: An NG tube with a guide wire, a syringe, water, Tegaderm, DuoDerm, no-sting barrier film if over 1 month of age, water soluble lubricant, a pH strip, scissors, and a waterproof permanent marker.

The next step is preparing the tube. First wash and dry your hands really well. Then remove the two from the package and prepare the tube. Make sure the stylette is in the straight port. Attach a syringe with 5 mL of water to the side port and push water through the tube. Check that the water is only coming out of the opening at the end of the tube. Remove the syringe and let all the water drip out of the tube and close the side port.

Now, we have to measure to know how far to insert the tube. Hold the tube by the end with the hole and measure from the tip of your nose to the tip of your earlobe and then to the stomach, halfway between the bottom of the breastbone and your belly button. Always double check this with an adult.

Mark this point on the tube with a waterproof permanent marker. Choose the nostril to insert the tube, and choose a different one every time you insert the tube. If you're using the nosting barrier, swab it onto your cheek where you will be putting the DuodDrm and let it dry. Measure and cut a piece of DuoDerm to fit on your cheek.

Dip the end of the tube into the lubricant. Insert the end of the tube into your nostril aiming towards the back of your throat and then downward. Gently push the tube downward to the marked point on the tube. Always refer to your educational materials for troubleshooting. Then remove the stylette and close the straight port.

Once the tube is in place, secure it with the Tegaderm by placing it as close to the nose as possible.

Now, we have to check that the tube is in the stomach. Attach a syringe with 5 mL of air to the side port. Flush the tube with the air to clear the tube of any fluid. Then, slowly pull back on the plunger to get stomach contents.

Push the fluid onto the pH strip and compare the results to the color chart on the bottle as you were instructed by your doctor.

Once you have confirmed that the tube is in the stomach, flush with the amount of water or air as you were taught to use.

Von: You're all finished. You did a great job; you should feel very proud of yourself. Watch this video as many times as you need to insert your NG tube and ask your doctor any questions. Remember, it's always OK to ask an adult for help. Thanks for watching.

Female: Check out the Children's Hospital of Philadelphia website at chop.edu for more information, and contact your provider with any additional questions.

Related Centers and Programs: Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, Hepatology and Nutrition