Introduction:
It is the process of delivering the food and nutrients required by the patient's body through a tube. The tubes used for this process are known as nasogastric tubes. These are thin, long, flexible tubes placed through the mouth into the stomach. Nasogastric can be split to denote “naso” meaning nose, and “gastric”, related to the stomach. So, it is a temporary connecting tube between the mouth and the stomach. The nasogastric tube passes through the mouth, then to the esophagus, and finally into the patient's stomach. It is usually used only at the most for six weeks. These tubes are commonly known as feeding tubes. This nasogastric intubation and feeding are used in both children and adults.
Based on the usage and function of nasogastric tubes are available in two forms. The types are single-lumen type and double-lumen type. The single-lumen nasogastric tube is used mainly to deliver food and medications into the stomach. As the name suggests, a single lumen has only one outlet. On the other hand, the double-lumen nasogastric tubes, as the name suggests, have two outlets that help remove contents from the stomach.
What Are the Uses?
Nasogastric tubes are used mainly for feeding the patient through the tube and removing any substance from the stomach which can have harmful effects if present. The patient receives the medications and food directly into the stomach through the feeding tube. The food and medicines are given in the form of liquid. The liquid passes along the tube and gets emptied over the stomach. The patient's digestive system absorbs the required contents from it.
The nasogastric tube is used in cases where the patient does not receive enough nutrients through eating or if any difficulty presents in swallowing or in unconscious patients or after any surgery. It can be used in premature infants. In addition, it is also used in patients who have faced accidents or trauma over the head and neck region and in bedridden patients due to serious illness. Naso gastric tubes can send dyes (contrast agents) to the stomach for better viewing of the stomach while taking the X-rays.
The tube is also used to remove any contents present in the stomach out through the nose. It can remove any toxins generated or present in the stomach. It can be helpful in the case of gastrointestinal surgery to suction the contents out. When the stomach is filled to capacity or bloated, suctioning using the nasogastric tube helps with relief. It can also be used to rectify very small obstructions present in the stomach.
How Is the Procedure Done?
Before starting the nasogastric tube intubation, if the patient is adult and conscious, they are informed about what will be done. This procedure is often done in hospitals and can be done at home by expert healthcare professionals. First, a signed informed consent form must be obtained from the patient or the bystanders before the procedure. Then, the healthcare provider gives instructions about what the patient should do. The nasogastric tube intubation procedure is not painful but causes discomfort while the tube is inserted.
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In this procedure, the patient is made to sit straight with the head slightly slanting.
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The healthcare provider estimates the tube length required from the nose to the stomach.
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At the tip of the tube, which is descending towards the stomach, a lubricating gel is applied for easy movement.
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An anesthetic spray of Lidocaine is used to anesthetize the areas through which the tube passes. It helps to reduce pain and discomfort felt during the procedure.
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The tube is passed through the nose.
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The tube then reaches the back of the throat and the esophagus.
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Then, the patient is asked to sip some water, which helps the movement of the tube into the stomach.
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After placement of the tube, it is checked whether the placement of the tube is correct or not by taking an X-ray.
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A chest X-ray helps to view the tube's position in the patient.
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After confirming the proper placement of the tube, the end, which is present at the nose, is placed securely using tape on the face or nose.
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The tip present at the nose will have a covering that will prevent the entry of microorganisms through the tube.
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The tube is now ready for its usage.
After using a nasogastric tube for feeding food or medication or removing any contents from the stomach, it should be maintained well. The risk of infection associated with this is very high, which can lead to serious issues. After using the tube, it must be cleaned by adding slightly warm water into the tube. This method allows the removal of contents stuck onto the tube's walls. After this, a cap is placed over the tube for the closure. After each procedure, the surrounding areas of the tube, the nose, and the face, should be cleaned properly. Again, it can be cleaned using warm water.
What Are the Complication or Risk Factors Observed?
The procedure for placement of the tube is a crucial factor. If it is done, many complications can be avoided. On the other hand, if the tube placement goes wrong, it may cause injuries to the nose, throat, esophagus, and stomach.
The other associated complications include:
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Vomiting.
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Pain sensation or cramping in the stomach.
Other signs are:
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Bleeding from the nose and mouth.
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Ulcer formation in the areas where the tube passed.
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Food substances coming back through the tube.
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Dislodgement of the nasogastric tube.
Nasogastric intubation can be used only for six weeks. Prolonged use of more than six weeks leads to serious problems.
Conclusion:
Nasogastric feeding is very helpful in patients with difficulty taking food and medicines. The procedure causes some difficulty, but the result appears good. Nasogastric tube feeding can be used in all age groups, from infants to old age. This type of feeding helps deliver the appropriate amount of nutrients required for sustaining the patient's life. Therefore, nasogastric tube intubation and feeding can be life-saving mechanisms in patients.
