A Comprehensive Guide to Nasogastric (NG) and Nasoenteric (NE) Tubes: What You Need to Know

Introduction

Nasogastric (NG) and nasoenteric (NE) tubes are medical devices that are inserted through the nose and into the stomach or small intestine, respectively. They are used for a variety of purposes, including feeding, administering medications, and draining fluids.

In this article, we will provide a comprehensive overview of NG and NE tubes, including their indications, insertion techniques, management, and complications.

Indications for NG and NE Tubes

NG and NE tubes are used for a variety of reasons, including:

• Providing nutrition to patients who are unable to eat or drink safely
• Administering medications that cannot be given orally
• Draining fluids from the stomach or small intestine
• Decompressing the stomach or small intestine
• Flushing perforated organs and fistulous tracts

Types of NG and NE Tubes

There are a variety of different types of NG and NE tubes available. The type of tube that is used will depend on the specific needs of the patient.

• Standard NG tubes are made of a soft, flexible material and have a single lumen.
• Weighted NG tubes have a weight at the tip of the tube to help it pass through the stomach and into the small intestine.
• Double-lumen NG tubes have two lumens, one for feeding and one for drainage.
• Triple-lumen NG tubes have three lumens, one for feeding, one for drainage, and one for medication administration.
• PEJ tubes (percutaneous endoscopic jejunostomy) are surgically inserted into the small intestine. They are used for long-term feeding and medication administration.

Insertion of NG and NE Tubes

NG and NE tubes are typically inserted by a nurse or doctor. The procedure is generally well-tolerated, but it can cause some discomfort.

Materials:
* NG or NE tube
* Water-soluble lubricant
* Nasal speculum
* Syringe
* Stethoscope

Procedure:
1. Explain the procedure to the patient and obtain their consent.
2. Position the patient in a sitting or semi-sitting position.
3. Apply a water-soluble lubricant to the tip of the tube.
4. Insert the nasal speculum into the patient's nostril.
5. Advance the tube through the nostril and into the pharynx.
6. Listen for a "whooshing" sound over the epigastrium with a stethoscope. This indicates that the tube has entered the stomach.
7. If the tube is being inserted into the small intestine, advance it until the "whooshing" sound is no longer heard.
8. Secure the tube to the patient's face with tape or a tube holder.

Management of NG and NE Tubes

NG and NE tubes require regular care and maintenance. This includes:

• Checking the tube placement every 4-8 hours.
• Flushing the tube with water every 4-8 hours.
• Changing the tube every 2-4 weeks.
• Monitoring the patient for complications.

Complications of NG and NE Tubes

NG and NE tubes can cause a variety of complications, including:

• Nausea and vomiting
• Diarrhea
• Nasal irritation
• Sinusitis
• Pneumonia
• Tube dislodgement
• Tube obstruction

Why NG and NE Tubes Matter

NG and NE tubes play an important role in the care of patients who are unable to eat or drink safely. They provide a safe and effective way to deliver nutrition, medication, and drainage to the gastrointestinal tract.

Benefits of NG and NE Tubes

NG and NE tubes offer a number of benefits, including:

• Improved nutritional status: NG and NE tubes can help to improve nutritional status in patients who are unable to eat or drink safely.
• Reduced risk of complications: NG and NE tubes can help to reduce the risk of complications, such as dehydration, malnutrition, and pneumonia.
• Improved quality of life: NG and NE tubes can improve quality of life for patients who are unable to eat or drink safely by providing them with the nutrition and medication they need to live a full and active life.

FAQs

Q: How long can NG and NE tubes be left in place?
A: NG and NE tubes can be left in place for up to 4 weeks.

Q: What are the signs and symptoms of NG and NE tube complications?
A: The signs and symptoms of NG and NE tube complications include nausea, vomiting, diarrhea, nasal irritation, sinusitis, pneumonia, tube dislodgement, and tube obstruction.

Q: How can I prevent NG and NE tube complications?
A: You can prevent NG and NE tube complications by checking the tube placement every 4-8 hours, flushing the tube with water every 4-8 hours, changing the tube every 2-4 weeks, and monitoring the patient for complications.

Stories and What We Learn

Story 1:

A 65-year-old man with esophageal cancer was unable to eat or drink safely. He was admitted to the hospital and an NG tube was inserted. The NG tube provided the patient with the nutrition and hydration he needed to recover from surgery and receive chemotherapy.

What We Learn:

NG tubes can play an important role in the care of patients with esophageal cancer.

Story 2:

A 3-year-old child with cerebral palsy was unable to eat or drink safely. She was admitted to the hospital and an NE tube was inserted. The NE tube provided the child with the nutrition and hydration she needed to grow and develop.

What We Learn:

NE tubes can play an important role in the care of children with cerebral palsy.

Story 3:

A 50-year-old woman with Crohn's disease was experiencing abdominal pain and diarrhea. She was admitted to the hospital and an NG tube was inserted to decompress her stomach and small intestine. The NG tube helped to relieve the woman's pain and diarrhea.

What We Learn:

NG tubes can play an important role in the care of patients with Crohn's disease.

Step-by-Step Approach to NG and NE Tube Insertion

Materials:

• NG or NE tube
• Water-soluble lubricant
• Nasal speculum
• Syringe
• Stethoscope

Procedure:

1. Explain the procedure to the patient and obtain their consent.
2. Position the patient in a sitting or semi-sitting position.
3. Apply a water-soluble lubricant to the tip of the tube.
4. Insert the nasal speculum into the patient's nostril.
5. Advance the tube through the nostril and into the pharynx.
6. Listen for a "whooshing" sound over the epigastrium with a stethoscope. This indicates that the tube has entered the stomach.
7. If the tube is being inserted into the small intestine, advance it until the "whooshing" sound is no longer heard.
8. Secure the tube to the patient's face with tape or a tube holder.

Conclusion

NG and NE tubes are essential medical devices that play an important role in the care of patients who are unable to eat or drink safely. They can provide a safe and effective way to deliver nutrition, medication, and drainage to the gastrointestinal tract.

Resources

• National Institutes of Health: Nasogastric and Nasoenteric Tubes
• American Society for Parenteral and Enteral Nutrition: Enteral Nutrition
• American Association for Respiratory Care: Nasogastric and Nasointestinal Tubes