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Nasogastric intubation is a medical process involving the insertion of a plastic tube (nasogastric tube or NG tube) through the nose, down the esophagus, and down into the stomach. Orogastric intubation is a similar process involving the insertion of a plastic tube (orogastric tube) through the mouth. [1] Abraham Louis Levin invented the NG tube.
Usually a patient will cough or gag if the tube is misplaced, but most patients in critical care settings are sedated or comatose. If a nasogastric tube is accidentally placed in the trachea instead of the esophagus, the tube feedings will go into the lungs, which is a life-threatening situation. If the monitor displays typical CO
The gold standard for checking and confirming NG tube placement is to aspirate some fluid and check the pH level. The pH level of gastric secretions should be between 4-6. A secondary way to confirm placement (no longer the gold standard) is to auscultate using a stethoscope by placing the diaphragm of the stethoscope over the stomach and ...
Secondary methods of confirmation include oxygen saturation, chest x-ray, ultrasound, condensation in the endotracheal tube, equal chest rise, breath sounds heard on both sides of the chest (often with the assistance of a large tidal volume breath), and an absence of breath sounds over the epigastrium. No single method of confirming placement ...
A tracheal tube is a catheter that is inserted into the trachea for the primary purpose of establishing and maintaining a patent (open and unobstructed) airway. Tracheal tubes are frequently used for airway management in the settings of general anesthesia, critical care, mechanical ventilation, and emergency medicine. Many different types of ...
Gastric lavage involves the passage of a tube (such as an Ewald tube) via the mouth or nose down into the stomach followed by sequential administration and removal of small volumes of liquid. The placement of the tube in the stomach must be confirmed by pH testing a small amount of aspirated stomach contents, or x-ray.
For example, nasogastric (NG) tubes inserted through the nose and into the stomach can help remove stomach contents for patients who have a blockage further along in their gastrointestinal tract. After surgery, drains can be placed to remove blood, lymph, or other fluids that accumulate in the wound bed.
In gastroenterology, esophageal pH monitoring is the current gold standard for diagnosis of gastroesophageal reflux disease (GERD). It provides direct physiologic measurement of acid in the esophagus and is the most objective method to document reflux disease, assess the severity of the disease and monitor the response of the disease to medical or surgical treatment.