N/G tube insertion

nurseprnRN, BSN, RN · Feb 15, 2014

I think what we have here is an intercultural failure to communicate. OP, if you are not a student in the US and/or have some difficulty with English as a second language, I think you may be missing the point of the statement in an English textbook.

NG tubes do not cause aspiration. They are often placed to keep the stomach empty with suction to prevent stomach contents from rising up the esophagus and prevent aspiration.

In the US, if a patient regurgitates gastric contents into the pharynx, it is not necessary for a physician to clear the airway before the NG tube goes in (regardless of who places it)-- a nurse can suction to clear an airway. Generally, but not always, a physician prescribes the NG tube, but in some situations the nurse can place it based on independent nursing judgment.

If bronchoscopy is needed to clear actual gastric contents in lungs, that is a physician responsibility, but it could also be a huge emergency with a high rate of fatality, depending on how much got into the lungs and how long it remained there before it was removed. Small amounts of aspiration into the trachea can be cleared by a nurse using nasotracheal suction.

You originally asked if someone aspirates after vomiting, is it then OK to place an NG feeding tube. If someone is vomiting, it is not usually a good idea to put more material into the stomach until vomiting stops. That would increase risk of aspiration, but it's not the tube that causes it, it's the feeding.

If someone has no ability to prevent reflux of stomach contents into the esophagus, then a feeding tube inserted in the jejunum would be safer, to deliver feeding to the intestines below the stomach. This would decrease (but not eliminate) the risk of aspiration form stomach contents.

Is this what you were asking?