NG Tube Insertion and Removal: Clinical Nursing Skills | @LevelUpRN

Ellis demonstrates how to insert and then remove an NG tube. This includes drawing gastric residual and checking the pH. After the demonstration, Ellis provides additional tips about clamping the NG tube and using the blue pigtail.

Our Critical Nursing Skills video tutorial series is taught by Ellis Parker MSN, RN-BC, CNE, CHS and intended to help RN and PN nursing students study for your nursing school exams, including the ATI, HESI and NCLEX.

#NCLEX #HESI #Kaplan #ATI #NursingSchool #NursingStudent⁠ #Nurse #RN #PN #Education #LVN #LPN #ClinicalSkills #NGTube #nurseeducator

00:00 What to expect
00:30 Preparing NG tube patient
00:56 Preparing NG tube equipment
1:29 Measuring the NG tube
2:02 Preparing for NG tube insertion
2:28 Inserting the NG tube
3:17 Checking placement with pH
4:23 Anchoring with split-tape
5:32 Connecting to suction
6:05 Disconnecting from suction
6:17 What to do before removal?
7:03 Removing NG tube
7:40 Additional tips on clamping
8:31 The blue pigtail

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All of the nurses at Level Up RN are here to help! Cathy Parkes started helping her fellow classmates back when she was in nursing school, tutoring so they could pass their exams and graduate. After she got her BSN and started working as an RN at Scripps Encinitas Hospital, she started this YouTube channel to help nursing students around the world. Since then she has built a team of top-notch dedicated nurses and nurse educators who are focused on improving nursing education and supporting career advancement for nurses everywhere. With flashcards, videos, courses, organizational tools and more, we are singularly focused on helping students and nurses Level Up on their exams and nursing careers.

[huricanexify]

so helpful, thank you! as a student i love hearing expert tips from experienced nurses

[TheHuddleHub]

This is great information! Always check placement with an X-RAY, at my old hospital a patient died because it was in the lungs. The nurse was fired and an investigation was performed on the unit, doctors, etc. Getting an Xray will protect your patient and your license!

[monekiaroque]

I'm a RN who has Crohn's Disease, and unfortunately, I need to have NG tubes inserted during my more severe flare-ups. But, after I had a horrible experience with the first NG tube that I allowed a nurse to insert, I quickly determined that it is always best if I insert my own NG tube. I ask for the throat numbing spray, which the ER usually gets from the GI floor, where the EGDs are performed. I ask for the smallest tube I can get my hands on. I only have it inserted for light suction while I'm NPO for bowel rest the first couple of days. I don't get feedings or medications through the tubes. Then I have the tube soaked in warm/mildly hot water for a few minutes, while I get all of the supplies ready to go to make it pliable and as soft as possible (easy to swallow). I get a cup of tepid water to sip during insertion. There are always new nurses who are fascinated with this process when I'm dealing with these tubes for some reason. I even had a doctor say they wanted to see me do the last insertion. I always try to give them tips so that they don't damage the poor people they're working on any more than necessary. Insertion of these tubes can truly cause issues with the pharyngeal area, which is what happened to me the first time.

So, I spray the back of my throat just a little to help prevent discomfort. Don't do too much so that the patient can still feel things enough to be able to swallow. I blow my nose. I measure the tube for the length that I'll need to secure the tube at at the opening of the chosen nare. Keep in mind where the suction canister will be to help determine the nare you'll insert the tube into. It's not comfortable to have that tube reaching over you. I dip the warm tip lightly in room temperature water soluble lubricant, take a deep breath, grab my water, and begin to insert the tube. I usually angle my chin towards my chest, but don't put in too close. As I feel it getting to the back of my throat, I begin to take little sips of water and swallow while I push the tube gently down, going with the flow. If the tube hits something, be prepared to pull back a little (this has never happened to me) in order to go at it again. I usually swallow the tube quickly. Once I see that it's down past the esophageal sphincter, I gently push it down until I meet the marked measurement with the tip of my nose. Then, I secure the tube to the tip of my nose (that was already prepped with the alcohol or prep pad) and then to the shoulder of my gown. It's then hooked up to the suction. The whole process only takes a few minutes, and the nurses are always sitting there in awe watching me do this.

The most important thing for me is to be sure they know the tips and tricks in order to help others who aren't able to do all of this for themselves. Having a bleeding throat while you have to constantly swallow past a tube is no fun for these people. Be careful with blood thinners if they begin to bleed from this area too! During one of my stays, I refused the Lovenox injection they wanted to give me bc I am usually pretty mobile and do most things for myself whenever possible (I've been told that I'm the best patient EVER!). But after I got into it with one very pushy RN about my refusal of this medication, I had a large bleed from the area in my throat that was rubbing on the tubing during that stay! I woke up to hundreds of milliliters of blood in the canister! So, if I hadn't listened to my own judgement, I may not have awakened. Please, be careful with these people when they are unable to help themselves. And just listen to your patients, especially when they're educated on these things or have been going through their issues for quite a while.

To remove the tube, I always am sure to drink a whole cup of water. Then, I suction a good part of the water into the tubing and canister. If you don't do this, the gastric contents, which includes acid, can and often does get all into the pharynx and nose when it's being pulled out through them. That sucks so much! It hurts! Then, get them some tissue so that they can blow their noses. So, that's the tips of the trade to help your patients to the best of your ability, especially if they're alert.

[beartrap]

It’s scary how this channel knows what I’m learning during my program I have my check off for this skill tomorrow

[Chelsealove]

Im an LPN student but we do a lot of the stuff you teach on here. i love watching your videos... thanks for all you do <3

[restinginn]

Please make sure to listen to her when she says do not push past extreme resistance - There have been instances of the NG tube going through the cribriform plate and into the patient's brain. There are also instances of the NG tube going into the patient's lungs. Always get XR afterwards to confirm placement as she says!

[amandanegrete]

Thank you so much for sharing your expertise.

I was just hospitalized for a bowel obstruction.
I had absolutely NO IDEA anything was wrong until I started experiencing intense pain/cramping.

I KNOW that sounds crazy to a professional.
I thought the pain would pass.

It’s happened before but luckily I was at my fathers house this time and he called 911.

Long story short, the nurses and CNA’s who treated me were excellent.

I have always respected healthcare professionals, you all are AMAZING.

[flutatious_music]

I am a first year, first semester nursing student and I have to say that your videos are truly saving my life. So many helpful tips and tricks. I love your content! Thank you!🥰🥰

[Vundlathando]

Thank you, right on time.We did NG tube lab today💖

[annalanzotti-venrick]

This was very well explained step by step. Thank you so much for doing this video

[michaezell]

I had an NG tube put in during my hospital stay in April of last year and absolutely hated it. The feeling of the tube against the throat when you swallow is just awful.

[janegumi]

I am in my second year. Thanks for sharing, I have been watching my practice assessor doing it but there have been no much explanation on it, now I can repeat and repeat different videos. I am very greatful for your videos, thanks for sharing. I think I have a better knowledge about the NGT,

[Faith-nbdp]

Love these skills video, viewing in advance before ATI skills lab!

[simple_s_dat]

amazing... keep up the good work..! direct to the good stuff without the fluff

[shavionbates]

I have the cards but it’s always good to watch the videos, I’m a visual learner 😊😊. Thank you 🙏🏽

[Odinb]

Great video. Love the drinking water / swallowing technique, ph test, no other video shows.

[JemmaAbey]

Thank you for this video! I love your channel! Just one question, is the tube sterile? I’m just checking because obviously it goes inside the patient, but in the video the tube looked like it touched the bed, and the towel on the patient before insertion. Is this okay in normal practice?

[elizabeth]

when is continuous suction preferred over intermittent suction?

[kingofking]

Ms I like your all video and the way you teach

[janegumi]

Thanks a lot for sharing this video, it is very helpful.