What is a Nasogastric Tube?
A nasogastric (NG) tube is a flexible tube inserted through the nostril, down the esophagus, and into the stomach. It is used for various purposes including feeding, administering medication, and removing stomach contents. In the context of pediatrics, NG tubes are often utilized for children who are unable to eat by mouth due to medical conditions or surgical procedures.
Feeding difficulties due to prematurity, congenital anomalies, or neurological disorders.
Gastrointestinal obstructions or postoperative care.
Decompression of the stomach in cases of bowel obstruction or ileus.
Administration of medications or nutrients when oral intake is not possible.
Aspiration risk management in children with swallowing difficulties.
Preparation for NG Tube Insertion
Preparation is crucial for a successful and minimally traumatic NG tube insertion: Gather all necessary equipment: NG tube, lubricant, syringe, stethoscope, adhesive tape, and a pH indicator.
Explain the procedure to the child and their caregivers to reduce anxiety.
Measure the length of the tube: from the tip of the nose to the earlobe and then down to the xiphoid process.
Ensure the child is in a comfortable position, usually with their head slightly tilted forward.
Steps for NG Tube Insertion
The steps for inserting an NG tube in a pediatric patient include: Wash your hands and wear gloves to maintain
aseptic technique.
Lubricate the tip of the NG tube with a water-soluble lubricant.
Gently insert the tube into the nostril, aiming towards the back of the throat. Encourage the child to swallow or sip water if possible.
Advance the tube slowly and steadily until the pre-measured mark is reached.
Verify the placement by aspirating stomach contents and checking the pH (should be 1-5) or using a stethoscope to listen for air insufflation sounds over the stomach.
Secure the tube with adhesive tape to the child's cheek or nose.
Potential Complications
While NG tube insertion is generally safe, potential complications include: Nasal irritation or trauma.
Misplacement of the tube into the airway, leading to respiratory distress.
Esophageal or gastric perforation, though rare.
Infection or irritation at the insertion site.
Post-Insertion Care
After successful insertion, proper care of the NG tube is essential: Regularly check the tube's placement and patency.
Maintain cleanliness around the insertion site to prevent infection.
Monitor the child for signs of discomfort,
respiratory difficulties, or gastrointestinal issues.
Ensure proper administration of feedings and medications as prescribed.
Signs of respiratory distress or difficulty breathing.
Vomiting or abdominal distension.
Dislodgement or blockage of the NG tube.
Signs of infection such as redness, swelling, or discharge at the insertion site.
Conclusion
Nasogastric tube insertion is a common and essential procedure in pediatric care, providing vital support for children with feeding difficulties or medical conditions requiring gastrointestinal management. With proper preparation, technique, and post-insertion care, the risks can be minimized, ensuring the child's safety and well-being.
