Question

how to imsert NG tube and IV insertion

Answer 1

Nasogastric tubes are tubes inserted through the nose to the stomach in case of an ear, nose and throat abnormalities, oesophageal strictures,varices or diverticulae, or risk of infection. Nasogastric tubes of various sizes like 8, 10,12, 14,16 and 18 Fr are uses according to the age of the patient.

items needed

a clean tray containing sterile gloves, local anaesthetic jelly, nasogastric tube of appropriate size, 60 ml syringe, adhesive tape, kidney tray, pH strip, a glass of water.

procedure

• wash hands
• make patient in fowlers or semi-fowlers position
• wear gloves
• externally measure the required length from the tip of the nose to the ear lobe then to the xiphias sternum.
• lubricate nasogastric tube with anaesthetic jelly.
• insert the tube through wider nostril down.
• provide water and ask the patient to swallow which will helps to insert NG tube through the oesophagus.
• insert till tube reaches the measured length.
• confirm the position of tube
• aspirate gastric fluids using 60 ml syringe.
• check positions using pH test or x-ray.

Intravenous insertion

intravenous insertion is done with who needs fluid and electrolytes replacement, those under nothing per oral, critically ill patients.

procedure

• check doctors order
• identify patient
• take consent
• wash hands (sterile)
• prepare equipments needed
• explain procedure
• select site for iv insertion(avoid bends, paralysed extremities, choose non-dominant hands and distal veins)
• wear gloves and clean insertion site from the middle to outer in a circular motion- reduce microorganisms transmission.
• apply tourniquet 5-6 inches above the insertion site.
• stabilize vein by stretching the skin against insertion direction
• insert stylet-catheter at an angle of 20-30 degree
• check blood flow and insert the catheter into the vein by loosening stylet
• apply pressure on the vein above the tip of the catheter and remove the tourniquet
• reduce pressure over the vein and connect iv set adapter.
• begin infusion
• secure the catheter with adhesive tape and transparent dressing.
• remove gloves.
• label the site with date and time of insertion.