![]() The most common indication for placement of a nasogastric tube is to decompress the stomach in the setting of distal obstruction. A common pre-procedure maneuver is to loop the tube over one of the patient’s ears and place the tip at the patient’s xiphoid process and use this as an estimate for the length of the tube that should be inserted. ![]() All methods for estimation will have some margin of error. There are several methods to estimate the depth that an NG should be placed. Thus if one intended to place a tube through the nares and place it in the middle of the stomach, then approximately 55 cm of the tube should be inserted. While the stomach is a highly distensible structure and therefore, can vary in length, the empty stomach is generally around 25 cm long. ![]() The esophagus starts at the upper esophageal sphincter, the cricopharyngeus, and runs down through the diaphragm to the stomach for a length of approximately 25 cm. The length of the pharynx from the base of the skull to the start of the esophagus is 12 to 14 cm. 5 to 7 cm posterior to the nares the nasal sinus connects to the nasopharynx, which is continuous with the oropharynx. The nares are the anterior opening of the nasal sinuses. Depending on the intended purpose of the tube, there are different types, each specifically designed for its use. Nasogastric tubes are typically used for decompression of the stomach in the setting of intestinal obstruction or ileus, but can also be used to administer nutrition or medication to patients who are unable to tolerate oral intake. Abraham Levin first described their use in 1921. Nasogastric tubes are, as one might surmise from their name, tubes that are inserted through the nares to pass through the posterior oropharynx, down the esophagus, and into the stomach. Review the interprofessional team strategies for improving care coordination and communication of safe nasogastric tube placement.Outline the appropriate evaluation of the potential complications of safe nasogastric tube placement.Describe the technique of safe nasogastric tube placement.Identify the indications for nasogastric tube placement.It highlights the role of the interprofessional team in the use of NG tubes. This activity reviews the indications for the placement of nasogastric tubes and explains the pertinent anatomy, technique, equipment, and potential complications of placement of nasogastric tubes. ![]() They are most common in surgical patients but are useful in any patient population where gastric decompression or nutritional support is necessary. 3 A nutritional dosing weight uses a correction adjustment of 25% (see equation below) to avoid underfeeding (with ideal weight) or overfeeding (with actual weight).Nasogastric tubes are part of the standard of care in treating intestinal obstruction and can also be used to provide nutritional support. In obese patients (>20% ideal weight), this calculator uses a nutritional dosing weight.
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