Inserting NG tubes

[chenoaspirit, ASN, RN]

Ive inserted many thru the years, but Ive seen different nurses do it differently. I try to insert it fast while they are drinking ice water via straw. Ive seen others do it that way, but Ive also seen others do it really really slow, gradually advancing it. Which do you think is easier on the patient?

[Tait, MSN, RN]

I think it sucks no matter what, however I would rather have someone take their time than risk any injury.

Tait

[Creamsoda, ASN, RN]

Once I know its not comin out the mouth, then I tend to go fairly quick. I dont like torturing the poor patient. It bad enough. Having an NG is one thing im sure I would refuse if it was me in the bed (unless I was knocked out), so I really detest inserting them. Depends on the patient of course and sometimes I need to go slow.

[RNsRWe, ASN, RN]

Only go slowly enough that you're sure it's not coming out mouth, and then MOVE. No one likes that thing slowly sinking down their throat.

I always have the pt drink water through a straw. Also, having the HOB up as high as possible and their chin down as far as possible tends to improve the outcome and speed of insertion.

[RedWeasel, RN]

i go slowly--at first. I advance as they dry swallow. I usually get them to upright position throw like 3 pillows behind their head so their head is tilted down chin to chest almost (I say "tilt your chin down, it closes off your wind pipe and opens your food pipe"==It is the opposite remember for CPR, you tilt head back to open airway.) Then after I know it isn't in the mouth and I feel they are getting it in the esoph I pull a pillow or two back out. I do find if they do like a continuous cough/sneezy thing it is usually in the lungs--so don't advance. We need xray confirmation at our facility. I also have learned that when you insert the tube just to your initial measurement mark, it seems to not end up in stomach. I get to the end of the sternum and then add an extra 5 cm. It then ends up in the stomach I find. OF COURSE don't advance if there is resistance.

[Virgo_RN, BSN, RN]

I've only ever done it once, while I was still a student. It was "like butter". I was taught to do it more quickly, so as to minimize the discomfort to the patient, but to stop if you meet resistance, and to pull back if the patient is coughing or choking, as this means it went down the trachea rather than the esophagus.

[lpnflorida, LPN]

All I can say is, no do not ever ask me if I would agree to have it done. I highly doubt I would ouch. When there is no choice, please be gentle and put me out of my misery as safely and quickly as possible.

If at all possible knock me out first, hold my hand reassure me it is not as bad as I think it would be.

Yes, I have put in many of them. I would request a dobhoff for myself. I like the thought of a smaller lumen going up my nose, down my throat.

[pattyrn376]

I do the straw and ice water if they can swallow, dont if they cant, i am careful and slow and steady for the first 6-8 inches then I speed it up. as for me getting an NG, I had a bad car crash when I was in and out of conciousness, with 2 broken arms, back, shoulder, elbow and hand and still managed to pull that baby out as soon as I realized it was here. luckily they figured out my stomach was fine and didnt put it back in. feels like "up your nose with a rubber hose"

[Aneroo, LPN]

Only go slowly enough that you're sure it's not coming out mouth, and then MOVE. No one likes that thing slowly sinking down their throat.

I always have the pt drink water through a straw. Also, having the HOB up as high as possible and their chin down as far as possible tends to improve the outcome and speed of insertion.

I agree.

I've only ever done it once, while I was still a student. It was "like butter".

I think you mean "like buttah".