What are the benefits of OGs verses NGs?

[BeatsPerMinute, BSN, RN]

This is a question from my orientation packet. I am suppose to discuss it with my preceptor. She doesn't know the answer and the other nurses I've asked on the floor aren't sure either. My guess is that OGs are better for decompression, less prone to clogging (wider tube, I think?)... my MedSurg book doesn't specify one being better than the other. I was told once before but lost my notes on it. Anyone here have any guesses as to why OGs are preferred over NGs, especially in the ICU environment? Thanks.

[KatieMI, BSN, MSN, RN]

OG tube is staying in a very wide place of oropharynx, and so can move a bit from side to side. It prevents pressure related injuries, which can happen quickly in nasopharynx. This injuries may be severe and require subsequent plastic surgery.

Nasopharynx is approximately 1.5 cm from brain cavity, thus NG is absolutely contraindicated if cranial base fracture not excluded. There were multiple cases of NG tubes put somewhere quite near of hypophysis.

NG is more direct gateway to respiratory tract and associated with things from sinusitis to pneumonia due to development of bacterial biofilm.

[BeatsPerMinute, BSN, RN]

Ah, that's it! Sounds very familiar, thank you :)

[Here.I.Stand, BSN, RN]

Sounds good ^^^

If the pt is not intubated, unless there is a contraindication, we use NGs because they are more comfortable once in and easier to secure.

If intubated, OG makes sense since they have the ETT sticking out their mouth anyway, to put other tubes through the same orifice. And then we tape the OGT to the ETT, which is very secure. Plus plain and simple, they are easier for the pt to have placed.

My hospital stocks one type of tube, which we insert as OG or NG. So no difference in bore size.

[Dranger]

Our NG/OGs sizes are one in the same. We use OGs often in new intubated patients because it's easy to drop in and can be secured to the ETT. For longer term >1-2 days intubation we will use a dobhoff placed through the nasopharynx for feeding/meds.

[littlepeopleRNICU]

I work NICU now, but even in my adult days, the tube sizes were the same...only difference is route. They end up in the same place, so I don't think decompression would be better via one route over the other. The tube should do its job in that aspect no matter which way you put it down.

I have to agree with everyone else and say that with an intubated patient, it's a lot easier to use an OG. With my adult patients, we used NG if they were any sort of awake. It's usually more comfortable for them once it's down, you don't have to worry about it being "tongued" out by them talking, etc., and I've found that they usually gag less when it's going down NG too.

If you have a patient on any form of nasal oxygen, OG is probably better. If you've got the NG down, it's hard for the prongs to fit and actually do their job at oxygenating because of occlusion.