Summary of Key Points for OSCEs
Indications and Contraindications for NG Tube Insertion
| Indications | Contraindications |
| Gastric emptying, e.g. bowel obstruction, ileus | Patient refusal |
| Enteral nutrition | Basal skull fracture or other facial trauma |
| Gastric lavage or aspiration after poisoning or drug overdose | Recent nasal surgery |
| Administration of medication | Oesophageal strictures |
| Administration of contrast for radiological investigation | Known oesophageal varices |
Upper gastrointestinal bleed:
| Caution in unconscious patients, and in patients with coagulopathy |
| Identifying oesophagus and/or stomach on chest X-ray | Alkaline ingestion |
Figure 58.1 How to measure the required length of insertion of an NG tube. The tube is measured by placing the tip at the tip of the patient’s nose, and measuring the length from the tip of the nose, to the ear lobe/tragus and then to the sternum
Figure 58.2 (a) An adequately placed nasogastric (NG) tube. The key finding is that the tip of the NG tube is visible below the diaphragm. Although this X-ray clearly demonstrates the entire NG tube, often only the tip is radio-opaque. (b) A NG tube that has gone into the patient’s lung so must be withdrawn and reinserted.
Reproduced courtesy of Pennsylvania Patient Safety Authority
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