What is the care of nasogastric tube

A nasogastric tube is a medical tube that is inserted through the patient's nasal cavity to the stomach, passing through the pharynx to the stomach. The inserted nasogastric tube can be used for gastric lavage or to extract some waste from the stomach. It is a common treatment method, and the care of the inserted nasogastric tube is also very critical. First of all, you need to pay attention to the nasogastric tube so that it does not get damaged, and it needs to be fixed and kept hygienic.

What is nasogastric tube care?

use

When intubating, position the patient properly, clean and lubricate the nasal cavity. Tilt the patient's head back and insert the gastric tube at a 60° angle to the nostril, and continue to insert it into the nasopharynx; when the gastric tube is inserted to 15CM (pharynx), drip 1-2ML sterilized paraffin oil along the outer wall of the gastric tube, lift the patient's head, and make the lower jaw close to the chest wall to increase the curvature of the throat, so that the gastric tube can slide along the back wall and pass through the throat smoothly into the esophagus. At this time, ask the patient to swallow while slowly inserting the gastric tube to the required length and then fix it. Then check whether the gastric tube is in the stomach. After the gastric tube is successfully inserted, the gastric tube needs to be properly fixed. The method is:

Gastric tube

First, wrap a 3cm long tape around the gastric tube twice to mark the nostril, then use a 6-7cm tape to cross and fix the nose wing, then use a prepared 50-60cm long cloth belt (1.5cm wide) to wrap around the gastric tube at the nostril and tie a knot (do not affect the gastric tube drainage when tying the knot), then wrap both sides of the belt around the patient's head. Tie a slipknot on one side to strengthen the fixation of the gastric tube.

In addition to mastering the entire process, it is best to go to the hospital to learn the operation of the nurses to ensure the safety and success of the intubation and prevent sequelae such as mucosal damage and vocal cord damage.

Nursing points

1. Fix it properly to prevent it from being folded or falling out. A. To fix the gastric tube, white rubber tape should be applied to the tip of the nose and the tape should be changed every day.

B. The length of the gastric tube inserted should be appropriate, generally about 45-55cm for adults. If you suspect the gastric tube has come out, notify your doctor immediately. At this time, nasogastric feeding should be temporarily stopped and nasogastric feeding can only be continued after making sure that the gastric tube is in the stomach. [Note] Method to determine whether the gastric tube is in the stomach: Use a syringe to draw out the stomach contents from the gastric tube. Use a syringe to inflate the gastric tube and use a stethoscope to listen for the sound of air passing through water in the stomach. Insert the stomach tube into the water without escaping bubbles.

C. Keep the gastric tube open to prevent it from getting kinked. When moving or turning the patient, prevent the gastric tube from coming out or getting folded.

2. Ensure the patency of the gastric tube and flush and aspirate gastric juice regularly.

A. Rinse regularly, once every 4 hours. When flushing, you should choose a 5 or 10 ml syringe and use 3-5 ml of normal saline to flush the gastric tube according to the model of the gastric tube, surgical site, surgical method, etc. Be careful not to use too much force when rinsing. If there is resistance, do not force it forward to avoid damaging the stomach wall or anastomosis, causing bleeding or anastomotic fistula. If there is resistance during flushing, gastric juice should be withdrawn first. If gastric juice is withdrawn, it means the gastric tube is unobstructed and flushing can be continued. If gastric juice cannot be extracted or the flushing resistance is great, you should notify your doctor and receive timely treatment.

B. Gastric juice should be aspirated regularly according to the secretion of gastric juice, usually once every 4 hours. When aspirating gastric juice, the suction force should not be too great to avoid damaging the stomach wall and causing mucosal injury and bleeding.

3. Closely observe the color, nature, and amount of gastric juice and keep records.

A. Observe the color and properties of gastric juice: gastric juice is generally dark green (mixed with bile). If the color is bright red, it indicates bleeding in the stomach. If the color is brown, it indicates that there is old blood in the stomach. If there is a change in the color or properties of gastric juice, you should notify your doctor promptly and give appropriate treatment.

B. Accurately record the amount of gastric juice: If the amount of gastric juice is too much, you should notify your doctor and deal with it in time. Avoid causing water and electrolyte imbalance.

4. Gastric tube care

A. Clean your nasal cavity with a cotton swab dipped in water every day.

B. When changing the tape, wipe the facial skin clean before applying it again, and be careful not to apply it to the same part of the skin.

C. The exposed part of the nasogastric tube must be properly placed to avoid it from slipping.

D. Pay attention to the scale of the nasogastric tube every day. If it comes out, notify the medical staff.