Site Map	Insert a Naso-Gastric Tube

• Wash hands
• Introduce yourself and check the patient's identity
• Discuss procedure with the patient
• Set up a trolley including
  • Ryle's tube of appropriate size
  • Sterile water / K-Y jelly / Aqua gel
  • Disposable gloves
  • Spigot / bag to attach to the Ryle's tube
  • Tape
  • Vomit bowl
• Sit the patient upright
• Measure the anticipated lenght of insertion of the tube (cumulative distance)
  • The nose to the patients ear
  • From the ear to 2 finger-breadths above the umbilicus
• Moisten the end of the tube
• Slowly pass the tube down the nose
• Ask the patient to start swallowing, with or without the use of water
• If the patient coughs stop advancing and withdraw the tube until coughing stops before proceeding
• Stop inserting the tube at the desired length
• Tape the tube to the nose and side of the face
• Test correct placement of the tube
  • Pass 50ml of air down the tube while listening for bowel sounds over the epigastrium
  • Attempt to aspirate liquid stomach contents and confirm acidity using litmus paper
• Discuss the requisition of a chest x-ray to confirm the placement of the tube

	Any comments or feedback please contact me by email: Tom Williams