Patients in critical care units (ICUs) often face conditions that restrict them from eating or drinking normally. Nasogastric tubes (NG tubes) play a major role in such cases. These slim, flexible tubes are inserted through the nose and into the stomach.
NG tubes help doctors and nurses provide essential nutrients, remove excess stomach contents, and give medications when patients cannot manage by themselves.
The use of NG tubes in an intricate critical care setting however requires extreme caution. We will review in this article why and how these tubes are placed accurately in the body of patients.
Why are NG Tubes Used in Critical Care?
In critical care, NG tubes have diverse applications. The following are the main reasons why they are used:
- Nutrition and Hydration: Many intensive care unit (ICU) patients cannot eat or drink safely. Administering essential minerals and fluids through NG tubes helps them survive, maintain vigor, and enhance curing.
- Digestive Disturbances: These also drain off surplus gas or fluid from the stomach, hence decreasing pressure, vomiting, and accidental inhalation of stomach acid, which could cause harmful effects on the lungs if it occurred otherwise.
- Administration: Certain medications can be safely administered through an NG tube when swallowing tablets or capsules is impossible.
- Health Monitoring: Doctors and nurses sometimes use them to collect small samples of stomach contents. Doctors can monitor a patient’s condition by analyzing these samples and making informed decisions.
Process of Inserting NG Tubes
The nurse will begin the procedure by explaining how the procedure will be conducted to the patient when he is still awake. The patient is positioned comfortably with their heads slightly raised. The nurse needs a tube, lubricant, tape, and equipment for an NG tube insertion placement check. Some nurses recommend using pH devices to better understand the placement and avoid complications during the procedure.
Firstly, the nurse measures how much tubing is required. Then, they carefully lubricate one end of the tube before gently sliding it into a nostril and directing it downward towards the back of the throat. If necessary, the nurse asks the patient to swallow sips of water to help facilitate easier passage of the tube.
X-ray images are used to confirm placement, which becomes an important step in ensuring that tubes have reached the stomach and not the lungs. Depending on circumstances, other methods, like listening for air movement through a stethoscope or measuring acidity levels, may also be employed for this purpose.
Preventing Problems and Nursing Care
While NG tubes are vital tools, they do carry some risks. Tubes can become dislodged, get clogged, or cause irritation to the nose and throat. Nurses in the ICU are specially trained to minimize these risks and watch closely for any signs of complications.
Nursing care to be done:
- Checking Tube Location Regularly: Nurses make sure the NG tube stays in place within the stomach.
- Tube Maintenance: Rinsing out the tube helps prevent clogging and assures an effective supply of medications and feeding.
- Monitoring for Complications: Nurses watch out for symptoms like cough, different breathing patterns, and discomfort that may indicate danger.
- Patient Comfort: Clearing up the nose and mouth, giving oral hygiene, and repositioning the tube all help relieve irritation.
- Patient and Family Education: Where necessary, nurses elaborate on the purpose behind NG-tube insertions and their care to dispel any fears.
Improving NG Tube Procedures
Advances in technology and specialized equipment are continuously improving the process of NG tube insertion and care in the ICU. Let’s look at some of these developments:
- Ultrasound Guidance: In some ICUs, portable ultrasound can help nurses and doctors see the NG tube when it is being inserted. This real-time view could increase accuracy, reduce the need for X-rays, and probably make the process less difficult for patients.
- Endoscopic Assistance: In case of difficulties in passing NGT through the nose, a doctor may insert it with an endoscope (a flexible tube containing a camera). It is particularly useful in patients with a history of facial trauma or anatomical variations.
- Different Tube Types: Specialised NG tubes exist that are meant for specific uses in the ICU. Some have two channels that allow simultaneous feeding and stomach drainage. Others are made to be less irritating to patients who need long-term nasogastric tubes.
Bottomline
NG tubes are like lifelines for very sick patients who can’t eat or drink normally. Doctors and nurses use them carefully to give food and medicine and help patients feel better.
Moreover, new tools and special training help make sure these tubes are put in safely, especially for patients who need extra care. Nurses and doctors work hard to use NG tubes the right way so patients can get the help they need to get stronger.
