From the Guidelines
When inserting a nasogastric (NG) tube, you should mark the tube at a distance equal to that from the xiphisternum to the nose via the earlobe, which is typically 50–60 cm, as recommended by the guidelines for enteral feeding in adult hospital patients 1. To ensure proper placement, it's essential to follow a step-by-step approach:
- Measure the distance from the xiphisternum to the nose via the earlobe and mark the tube at this distance
- Lubricate the tube externally with gel or water and internally with water if a guidewire is present
- Check nasal patency by having the patient sniff with each nostril occluded in turn
- Insert the tube gently through the clearer nostril until it's visible at the back of the pharynx
- Advance the tube 5–10 cm as the patient swallows, repeating this process until the preset mark on the tube reaches the nostril
- Always confirm proper placement by checking the position of the tube before use, which may not require an x-ray, as stated in the guidelines 1. By following these steps and marking the tube at the recommended distance, you can help prevent complications and ensure the tube is placed correctly, which is crucial for maintaining the patient's quality of life and reducing morbidity and mortality.
From the Research
Marking for NG Tube Insertion
The marking for NG tube insertion is not explicitly stated in the provided studies. However, the studies discuss the effects of NG tubes on aspiration risk and patient convenience.
Aspiration Risk
- The study by 2 found that the risk of aspirating a small amount of fluid was not significantly different before and after NGT removal, regardless of swallowing function, cognitive level, or general functional level.
- The study by 3 also found no significant differences in aspiration status for liquid or puree food consistencies between patients with and without an NG tube.
Patient Convenience
- The study by 4 compared the convenience of NG tubes and gastrostomy tubes for gastric decompression in abdominal surgery, and found that NG tubes caused more subjective inconvenience than gastrostomy tubes.
- However, this study did not provide information on the marking for NG tube insertion.
NG Tube Placement
- The study by 3 suggested that it is not necessary to remove an NG tube to evaluate dysphagia, and that objective swallowing evaluation can be performed with an NG tube in place.
- However, this study did not provide specific guidance on the marking for NG tube insertion.