NG tube insertion question

gvrn13 · Nov 1, 2014

This is interesting to me. I'm a newish nurse in the ED, and anytime I've placed one it has always been with a seasoned nurse, and we have always used the swallow small sips of water trick. Not a full cup, but just when it hits that area where they feel like gagging it back up, a couple of sips will help it go down when other wise it wouldn't. I'm interested in what everyone has to say.

Loo17 · Nov 1, 2014

I have never used the water trick myself, probably because my first experience with NG tubes was with npo patients. I have successfully inserted at least 100 tubes.

In the alert patient, I position the patient upright and explain whats going to happen. If they have never had an NG before I let them know the insertion will be uncomfortable and want to make them gag but it is very important they just swallow and remember that once it is in they will feel better. I let them know that I am going to put the tube in as quickly as possible to decrease the discomfort and that it should only take 10 seconds or so. I let them know that It is common instinct to want to lift your chin up as the gag reflex starts and that I will help them by using my hand on their head to guide the chin back down if that happens.

After measuring distance to the stomach and lubricating the tip I help position their head with their chin to their chest and keep my hand there to help keep the head forward and just insert smooth and steady (not slow) encouraging them to swallow and saying "good almost there" in between. I have found that explaining to patients exactly what will happen and what to expect has helped a lot and have only encountered a small amount of patients that were too anxious to tolerate insertion.

DisneyNurseGal, BSN, RN · Nov 3, 2014

I have had my CNA use a piece of gauze before to tickle the patients neck instead of water, and that will usually do the trick.