NG Tube

Question 1

Explain the clinical indications for inserting an NG tube

Answer 1

Impaired swallowing e.g following CVA, neurological conditions, obstruction due to malignancy unconscious patients e.g. ITU Patients who are unable to meet their nutritional requirements solely from oral diet/fluids patients who are malnourished or at risk of malnutrition facilitate drainage of stomach contents

Question 2

Explain different types of tubes available and uses

Answer 2

Wide bore tube for removal of gastric content Fine bore tube inserted with a guide wire for nutrition Understand when tube placed for nutritional support the decision to feed is made by two clinicians (GEH)

Question 3

Explain the basic anatomy of the path of the NG tube

Answer 3

nasopharynx, oropharynx, laryngopharynx, oesophagus

Question 4

Explain some contraindications of NG Tube insertion

Answer 4

Absolute

Gastrointestinal obstruction

Nasal obstruction

Patient refusal

Relative

Fracture of the base of skull

Patients who have undergone major upper gastrointestinal surgery with an anastomosis

Patients who have or are receiving systemic anticoagulation

Varices

Any trauma or surgery to the nasopharynx, oropharynx or laryngopharynx

Question 5

Explain the main complications of NG tube insertio

Answer 5

Risk of misplaced tube e.g. into trachea or lungs

Feeding into misplaced tube

Risk of trauma/bleeding (epistaxis)

Perforation of oesophagus or pharyngeal pouch

Overfeeding patients who have undergone weight loss surgery (gastric band or slipper gastrectomy)