Passage of a nasogastric tube for feeding, drainage or decompression.
Indications
- • Gastric decompression (obstruction, ileus)
- • Feeding
- • Drug administration
- • Poisoning (limited)
Contraindications
- ⚠ Basal skull fracture (use orogastric)
- ⚠ Esophageal varices/stricture (relative)
- ⚠ Recent nasal surgery
Equipment
- • Ryle's tube 14–16 F
- • Lubricant
- • 20 mL syringe
- • Stethoscope
- • pH paper
- • Fixation tape
- • Cup of water (if awake)
Positioning
- • Sitting up 45–90°, neck slightly flexed.
Consent
- • Explain indication, benefits, alternatives
- • Explain risks & complications
- • Obtain written/verbal consent as per SOP
- • Document consent
Universal precautions
- • Hand hygiene
- • PPE — gloves, mask, eye protection
- • Aseptic technique
- • Sharps safety
- • Verify patient identity & site
Step-by-step (0/6)
Tap to complete
NEX distance — nose to earlobe to xiphoid.
Immediate complications
- ⚠ Coiling in mouth
- ⚠ Tracheal placement
- ⚠ Epistaxis
- ⚠ Vomiting/aspiration
Delayed complications
- • Sinusitis
- • Ulceration
- • Displacement
Recognition
- • Cough, cyanosis, respiratory distress
Initial management
- • Remove; reinsert
Prevention
- • Confirm placement
- • Position patient upright
Post-procedure observation
- • Vitals q15min × 1h then hourly
Monitoring
- • Site inspection
- • Symptom review
Documentation
- • Procedure note
- • Consent
- • Findings
Patient instructions
- • Report pain, bleeding, fever, worsening symptoms
Educational bedside guide. Perform only under supervision until competent. Follow local SOPs and consent policy.
