Gastric intubation

Gastric intubation, also known as nasogastric intubation, is a medical procedure that involves the insertion of a tube through the nose or mouth, down the esophagus, and into the stomach. This procedure is commonly used for feeding, administering medication, or draining stomach contents.

Procedure

Gastric intubation can be performed using different types of tubes, such as a nasogastric tube (NG tube) or an orogastric tube. The choice of tube depends on the patient's condition and the purpose of the intubation.

Nasogastric Intubation

Man with NG feeding tube

Nasogastric intubation involves the insertion of a tube through the nose. The procedure begins with the patient sitting upright. The tube is lubricated and gently inserted into one of the nostrils. The patient is encouraged to swallow to facilitate the passage of the tube down the esophagus and into the stomach. Once in place, the tube can be used for feeding, medication administration, or gastric decompression.

Orogastric Intubation

Orogastric intubation is similar to nasogastric intubation but involves inserting the tube through the mouth instead of the nose. This method is often used in patients who cannot have a tube passed through the nose due to nasal obstruction or trauma.

Indications

Gastric intubation is indicated in various clinical situations, including:

• Enteral feeding for patients who cannot eat by mouth
• Administration of medications
• Gastric decompression in cases of bowel obstruction or ileus
• Aspiration of gastric contents for diagnostic purposes

Complications

While generally safe, gastric intubation can lead to complications such as:

• Nasal or esophageal irritation
• Sinusitis
• Aspiration pneumonia
• Misplacement of the tube into the respiratory tract

Types of Tubes

Viasys Corflo NG tube

There are several types of tubes used for gastric intubation, including:

• Levin tube: A single-lumen tube used for gastric decompression
• Salem Sump tube: A double-lumen tube with an air vent to prevent suction damage to the gastric mucosa
• Dobhoff tube: A small-bore tube used primarily for feeding

Insertion Techniques

The insertion of a gastric tube requires skill and knowledge of anatomy. Proper technique is essential to avoid complications. The tube should be measured from the tip of the nose to the earlobe and then to the xiphoid process to estimate the correct length for insertion.

Verification of Placement

ET tube and NG tube marked

Correct placement of the tube is crucial. Verification methods include:

• Auscultation: Listening for air insufflation sounds over the stomach
• pH testing: Checking the pH of aspirated gastric contents
• Radiography: Confirming placement with an X-ray

Related pages

• Enteral nutrition
• Parenteral nutrition
• Gastrostomy
• Jejunostomy