එහෙම තනියෙන් නහේට බට දාගන්න පුළුවන් නම් බැරියැ
What happens before a nasogastric tube is placed?
A trained healthcare provider will carefully prepare you before placing the tube. They will:
- Explain the procedure and ask for your signed consent.
- Place you in an upright sitting position, if possible.
- Put on medical gloves. (They don’t have to be sterile).
- Lubricate the first few inches of the tube with a sterile lubricating gel.
- Numb your sinus cavity and throat with an anesthetic such as lidocaine.
- Measure out in advance the correct length of tube that they will need to insert and mark it.
How do they measure the correct length of nasogastric tube to use?
Healthcare providers use different techniques to estimate the length of the tube they will need to reach your stomach (or sometimes, the upper part of your
small intestine). The length is proportional to your body size, so they may measure it against other distances on your body. Or they may use general measurements: for example, 55 cm is the average length needed to reach the adult stomach.
What is the procedure for nasogastric tube insertion?
Your trained healthcare provider will:
- Insert the tube through one of your nostrils and aim it in a straight line toward the back of your throat. This is to avoid putting pressure on the roof of your sinus cavity.
- When the tube reaches the back of your throat, gently aim it down into your esophagus and slowly continue to advance it.
- Give you a cup of water with a straw to sip from, and ask you to take small sips and swallows. This will help pull the tube down through your esophagus. Alternatively, they may ask you to take a deep breath and hold it.
- Stop and withdraw the tube if you gasp, cough or show distress. They will try it again after a short break.
- Keep advancing the tube until it reaches the mark that indicates the correct length, then secure it with tape.
- Check to make sure the tube is in the correct place.
How do healthcare providers check the placement of the nasogastric tube?
Your provider must verify the correct placement of the nasogastric tube to prevent serious complications. They will do this using one of two tests:
- Chest X-ray. A chest X-ray is the most accurate way to check the placement of the NG tube, and experts recommend using it at least to check the initial placement. But it may not be possible or practical on a regular basis. Frequent exposure to X-ray radiation isn’t advised, and if you are going to need the tube for some time, you may be using it and checking it at home.
- Aspirate pH test. The next best way to check the placement of the tube is with an aspirate pH test. You or your provider will suction out a small amount of fluid and test it for acid content. If the tube is placed correctly in your stomach, the aspirated fluid should have stomach acid in it, which will give it a lower pH. This test is useful for quick checks during your intubation.
Is a nasogastric tube painful?
It can be a little uncomfortable, but hopefully not acutely painful. Healthcare providers can take certain steps to minimize your discomfort before, during and after insertion. For example:
- Give you an anesthetic lozenge to help numb your upper GI tract before installation.
- Administer anesthetic to your nose cavity and your throat.
- Lubricate the tube and use a gentle technique during insertion.
- Secure the tube well with tape so that it doesn’t move and cause friction.
- Gently clean and use topical skin treatments where the tube touches your skin.
- Look for signs of irritation at the site of insertion and switch nostrils if necessary.