¿CÓMO COLOCAR UNA SONDA NASOGÁSTRICA?

Summary

This video tutorial explains the process of nasogastric intubation, detailing the procedure of inserting a tube through the nose or mouth into the stomach for therapeutic or diagnostic purposes. It covers the objectives, indications, precautions, and step-by-step instructions for effective execution. The tutorial emphasizes patient safety, proper equipment, and handling techniques. Additionally, it highlights the importance of correct tube placement, the methods for verifying placement, and the necessary care during and after the procedure. It also provides tips on patient comfort and proper communication throughout the process.

Takeaways

• 😀 The nasogastric (NG) tube is inserted through the nose to the stomach for therapeutic or diagnostic purposes, while the orogastric tube is inserted through the mouth.
• 😀 NG tube procedures are used to provide direct access to the stomach for drainage, medication, nutrition, gastric lavage, and to prevent aspiration in patients with altered consciousness.
• 😀 The Levin tube is used for short-term drainage (8-15 days), while the Flexiflow tube is used for longer durations (3-4 months) for enteral nutrition and medication.
• 😀 In cases of skull fractures, facial bone fractures, or nasal blockage, the nasogastric route is contraindicated, and oro-gastric insertion is preferred.
• 😀 Lubricants for inserting the NG tube must be water-soluble to prevent complications.
• 😀 If a patient experiences coughing, cyanosis, or respiratory distress, the NG tube should be removed immediately as it may have entered the respiratory tract.
• 😀 Never use force to insert the NG tube; it should be done gently, with the correct angle, to avoid injury or discomfort.
• 😀 The insertion procedure should be done with the patient in an elevated position (not lying flat), and patient cooperation is essential during the process.
• 😀 The correct NG tube placement is confirmed by aspirating gastric contents, injecting air into the tube, or checking for the lack of air bubbles in a water container.
• 😀 After confirming proper placement, the NG tube should be secured using medical tape (micropore) and monitored regularly to avoid skin damage or displacement.

Q & A

What is a nasogastric tube (NGT) insertion procedure?

The nasogastric tube (NGT) insertion is a medical procedure where a tube is inserted through the nose and into the stomach for therapeutic or diagnostic purposes. If the tube is inserted through the mouth instead of the nose, it is called an orogastric tube insertion.

What are the primary indications for performing a nasogastric tube insertion?

The main indications for NGT insertion include providing direct access to the stomach for drainage, administering nutrition or medications to patients who cannot swallow, performing gastric lavage, alleviating gastric distension, obtaining gastric content samples for diagnostic purposes, and preventing aspiration in patients with altered consciousness or intubation.

What are the different types of nasogastric tubes, and how long should they be used?

The Levin tube is used for gastric drainage, lavage, or medication administration and can stay in place for 8 to 15 days. For enteral nutrition, a siliconized or Flexiflow tube is used, which lasts 3 to 4 months. If longer access is needed, gastrostomy may be considered.

What are the contraindications for nasal insertion of a nasogastric tube?

Nasogastric tube insertion through the nose is contraindicated in cases of skull base fractures, facial bone fractures, or nasal obstruction. In these situations, orogastric insertion should be performed instead.

What precautions should be taken when lubricating the nasogastric tube?

It is essential to use water-soluble lubricants for nasogastric tube insertion. Lipid-soluble lubricants should be avoided. Additionally, avoid any sharp or abrupt movements to prevent injury to the patient.

How should the healthcare provider position the patient during the nasogastric tube insertion?

The patient should not be in a supine position. The head should be elevated to facilitate the correct insertion path. This helps prevent discomfort and ensures the tube follows the correct trajectory.

How is the correct length of the nasogastric tube determined?

The correct length is determined by measuring from the tip of the nose to the earlobe, then continuing to the xiphoid process (the lower part of the sternum). The tube is marked at the appropriate length to guide insertion.

What should the healthcare provider do if they encounter resistance while inserting the nasogastric tube?

If resistance is encountered, the healthcare provider should not force the tube but should gently attempt again. It may also be necessary to change the nostril for insertion if resistance continues.

How is the correct placement of the nasogastric tube verified?

The placement is verified through several methods: injecting air into the tube and listening for a sound, aspirating gastric contents with a syringe, and visually inspecting the tube in a water container to check for air bubbles.

What steps should be followed after verifying the tube's correct placement?

Once correct placement is verified, the tube should be secured with micropore tape. Regular monitoring of the insertion site is essential to prevent skin irritation. Additionally, instructions should be provided to the patient and family about tube care and maintenance.