UNCONTROLLED WHEN PRINTED
Indications

Gastric tube insertion involves the placement of a dual lumen tube into the stomach via the oro/nasopharynx to facilitate gastric suctioning and /or decompression. Indicated in demonstrated gastric decompression, including maintenance of a decompressed state after endotracheal intubation.

  • Nasogastric: Insertion via the nose
  • Orogastric: Inserted via the mouth
Contraindications
  • Base of skull fracture (Naso gastric insertion contraindicated).
Patient Factors & Considerations
  • Passage of the tube into the trachea
  • Coiling of the tube in the posterior pharynx
  • Head trauma
  • Max of 2 attempts and should not be undertaken in preference to other urgent interventions
Procedure
  • Identify the appropriate size:
    • Paediatric: FG 8-10
    • Adult: FG 12-16
  • Measure the length from the tip of the patient’s nose to the earlobe and then to the xiphisternum.
  • Lubricate the end of the tube
  • Insert the tube into the oral/nasal cavity and direct the tube downward through the oropharynx to the premeasured length
  • Examine oral cavity during insertion to detect coiling
  • Laryngoscopy and a Magill forceps may be required to assist placement
Success
  • Confirm placement by aspirating gastric content with a 50ml catheter syringe and check pH with pH paper (pH should be 5,5 or below)
  • Secure tube with tape onto nose or side of face
  • Connect drainage bag to tube/suction as required
  • Success will be evidenced by effective gastric suction / decompression of the gastrium
Discontinue
  • If resistance is met during insertion, stop advancement and adjust direction slightly before reattempting
Additional Information
  • Pulmonary aspiration
  • Oesophageal perforation
  • Intracranial placement
  • Trauma to nasal / oropharynx with associated bleeding.

References
References

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