NG Tube — Insertion & Verification
ProceduresThe steps
- Measure: nose → earlobe → xiphoid (NEX); mark it
- High Fowler's, chin slightly down; lubricate
- Advance through the nostril aiming back and down; have the patient sip water and swallow as you pass the pharynx
- Stop at your mark; secure temporarily
- VERIFY before anything goes in: X-ray is the gold standard for initial placement (policy-dependent); pH aspirate ≤ 5 supports gastric
- Mark the exit point at the nostril and document the external length — re-check before every use
🛡 Never skip
Coughing, choking, or inability to speak during insertion = pull back, you may be in the airway Auscultating an air bolus ('whoosh test') is NOT acceptable verification — it cannot distinguish lung from stomach Re-verify external length before each feed/med — migration happens
Common mistakes
- Feeding before radiographic confirmation on initial placement
- Pushing through resistance
- Not flushing before AND after meds — clogged tubes come from this
Source: Lippincott Nursing Procedures, 9th ed.; AACN Practice AlertReference only — verify against your facility's policy.
