Nasogastric tubes for stroke patients

Patients who have had a stroke due to a blockage in the heart are usually left partially or completely paralyzed and unable consume their own food. Nasogastric, or NG, tubes are often placed in patients who cannot consume their own food or may have trouble digesting what nutrients are able to make it to the stomach. NG tubes are usually not uncomfortable for the patient if positioned and placed correctly. The purpose of a nasogastric tube is to aspirate the contents of the stomach such as food, air or blood. It is important to be sure that the drainage container is emptied frequently so the tubes can flow appropriately. NG tubes can also be used to place fluids into the stomach for feedings or lavages. There are many steps to inserting a nasogastric tube. The most important is making sure that the patient is propped in an upright position. Using the NG tube as a measuring device determine the length of the NG tube to be passed by measuring the length from the earlobe to the nose and then from the earlobe to the xiphoid process. These measurements should then be added together to get the total length needed for the tube. The patient should blow his or her nose before the tube is placed if able. Lubricate the first 6 inches of the NG tube with a water soluble lubricant. The largest nostril should be chosen and then the NG tube can be passed through the nostril to the nasopharynx. Once in the pharynx the patient should be instructed to swallow either mimicking the action or by sipping on small amounts of water. If awake and alert have the patient place chin to chest to allow the tube to pass easily. Allow the full length of the tube to be passed until the marked section that was previously measured. You can be sure that placement is correct by doing a chest x-ray. Once placed correctly, you will see gastric contents begin to come through the tube and empty into the container. The patient should be able to cough and speak normally. Once it is determined that the NG tube is placed correctly, it needs to be secured. Place one end of tape from the bridge to the tip of the nose and the other end wrapped around the tube itself. If possible the nose should be clean and prepped prior to securing with tincture of benzoin. The Tube should also be secured to the chest of the patient to prevent being pulled out.