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nasogastric tube (NGT) placement (gastric intubation)
Placement of a thin tube through the nasal passage, into the nasopharynx, through the esophagus & into the stomach.
Indications:
1) evaluation of upper GI bleed
2) aspiration of gastric fluid content
a) poisoning
b) gastric acid secretion
1] gastrinoma
2] pernicious anemia
c) cytology for gastric cancer
3) identification of the esophagus & stomach on a chest radiograph
4) administration of radiographic contrast to the GI tract
5) gastric decompression
6) bowel rest in the setting of small-bowel obstruction
7) administration of medication
8) short-term enteral nutrition
9) bowel irrigation
Procedure:
1) external measurement
-> nostril or ear to xiphisternum
2) tube stiffened by ice water or stylet
3) placement verified by
a) injecting air & auscultating
b) aspirating gastric acid
c) X-ray
Complications:
1) aspiration
2) ulceration of nasal or esophageal tissues, leading to strictures
3) discomfort from tube
4) tube dislodgement
5) erosions of gastric mucosa
6) gastric distension
7) diarrhea
8) emesis
9) aspiration pneumonia
10) imposition of restraints
Related
enteral nutrition
feeding tube
gastric intubation
nasojejunal tube
Specific
nasogastric tube for upper GI hemorrhage
General
enteral tube
References
- Harrison's Principles of Internal Medicine, 14th ed.
Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 479
- Shlamovitz GZ
eMedicine (Medscape): Nasogastric Tube
http://emedicine.medscape.com/article/80925-overview