first clean your hands with soap and water or alcohol-based hand gel
Then clean your work surface with soap and water or a disinfecting wipe
Cover your work surface with a clean cloth or towel
Assemble the supplies you need to insert an NG feeding tube.
A new NG Tube, which is the proper size and length.
A clean container such as a measuring cup with the type of water recommended for flushing the tube,
a permanent marker,
flexible measuring tape,
tape or other device to secure the tube,
and a cup of water and a straw to help the patient swallow as you insert the tube.
If you are inserting the tube into an infant, you'll need a bottle or pacifier and a blanket for swaddling.
Open the NG Tube package and remove the tube.
Set the package on your work surface.
Position the insertion end of the NG Tube at the tip of the patient's nose.
Hold the insertion end of the tube at the tip of the nose with one hand and
extend the tube to the middle of the earlobe.
Then, hold the tube at the earlobe with one hand and
extend the tube to the spot between the bottom of the
sternum and the bellybutton.
Mark the spot between the bottom of the sternum,
and the belly button on the NG Tube using a permanent marker
This measurement is the patient's insertion length.
Write down the insertion length.
Measure from the insertion length mark to the feeding end of the NG Tube.
This measurement is the patient's external,
or extra, tube length.
Write down the external tube length.
This number is used to check tube placement each time you use the tube for liquid food, water, or medicine.
If you are inserting an NG Tube into the nose of a small child or infant,
swaddle the child in a blanket to keep the arms and legs secure.
Put on the non sterile gloves
Seat the patient in an upright position unless the patient's healthcare provider tells you to use a different position.
For small children or infants, use a baby seat or Boppy to support the child.
Select the nostril that is most open to airflow for NG Tube insertion.
Cover the insertion end of the NG Tube with water-soluble lubricant.
Have a patient look straight ahead.
For small children and infants, hold the child's head, so the child is looking straight ahead.
Ask the patient to swallow sips of water while you insert the NG Tube.
Offer a glass of water with a straw for older children and adults
or a bottle or pacifier to infants or small children
Swallowing helps the tube slide more easily into the patient's stomach.
Gently place the insertion end of the NG Tube into the patient's nostril.
Point the tip of the tube towards the ear on the opposite side of the head as the nostril.
Thread the NG Tube into the back of the nose and down the back of the throat.
If the Tube stops moving easily, tip the patient's head forward.
Continue to insert the NG Tube slowly and gently.
Never Force the NG Tube to move.
If the tube does not move easily or you see the tube coming out of the mouth,
remove the tube and try again in the other nostril.
Stop inserting and remove the NG Tube immediately if the patient experiences any of the following symptoms:
wheezing, continuous cough, change in color
Difficulty breathing or inability to breathe,
inability to make sounds, continuous gagging or choking, vomiting,
unexplained signs of discomfort or pain,
or change in quality of cry for an infant or toddler.
If none of these symptoms occur, continue to advance the NG Tube
until the spot you marked for insertion length is just outside the nose.
Use tape or a securing device to hold the NG Tube securely to the nose and cheek.
Before using the tube check the NG tube placement.
For a refresher on how to check the placement of an NG Tube,
click here to watch the video.
Once to placement is confirmed,
you may begin using the NG feeding tube to deliver liquid food, water, or medicine