NG tube insertion

Question 1

Give 2 contraindications of NG insertion

Answer 1

Possible base of skull # (e.g. in severe mid-face trauma)

Recent nose surgery

Question 2

How do you measure the length of an NG tube?

Answer 2

From the bridge of the nose to ear lobe to 5 cm below the xiphisternum

Question 3

Why should you keep checking in the patient’s mouth?

Answer 3

To make sure the tube isn’t just coiling in their mouth

Question 4

What can you ask the patient to do to make advancing the tube easier?

Answer 4

Swallow sips of water

Question 5

What do you need to do once the tube is inserted

Answer 5

Aspirate to check the pH

Question 6

If correctly inserted, what should the pH be?

Answer 6

pH <4

Question 7

What should you do if pH >4 or indicated in trust guidelines

Answer 7

Xray

Question 8

On an x ray what 3 things indicate correct NG tube placement?

Answer 8

Goes down the midline of the thorax
Bisects the carina
Tip is below the diaphragm