The nasogastric tube moves through the nose into the buccal cavity to the throat where it routes to the stomach. Another major use for the nasogastric tube is to provide the patient with medicines that the patient could not take otherwise.
Nasogastric tubes come in various standard depths that are marked on the tubes. The healthcare must measure the distance from the patient’s nose to the location of the xyphoid process. Gastric tubes are marked at the measured length before insertion to ensure adequate reach without any danger of clogging due to excess tube length. Before insertion, it is common to lubricate the gastric tube at the insertion end using local anesthetics such as 2% xylocaine gel. Other than local anesthetics, nasal vasoconstrictor sprays may be used as well. The nasogastric tube is then inserted into one of the patient’s anterior nares.
Care has to be exercised when guiding the tube through the patient’s nasal cavity into the throat region. The tube is directed downwards and backwards as it is inserted. If a patient is wake during the insertion process, they may gag as the gastric tube reaches the oropharynx and then enters the posterior pharyngeal wall. In such a case, the patient is asked to mimic swallowing or is provided with some water to sip. As the patient imitates swallowing, the tube is inserted further. As soon as the tube moves beyond the pharynx and into the esophagus, it slides easily down into the patient’s stomach. ...
The removal is done slowly especially if the patient is wake. In case that the patient develops a gag, he is instructed to sip some water or to imitate swallowing to ease the congestion. Once the gastric tube is removed, the site is cleaned using any acceptable anti-bacterial agent such as povidone iodine. After cleaning, the site dries itself in air while the healthcare provider prepares the Foley catheter sized between 14 and 18 fr. The catheter is sterilized before use after which it is inserted into the patient’s system. Before insertion it is ensured that the balloon of the catheter is not leaking through a trial insertion of sterile water. The Foley catheter is inserted into the patient’s system comparable to the gastric tube insertion with little differences in the overall procedure. Once the Foley catheter is in position, the balloon is secured in position by inflating it with 10 to 15 cc of sterile water. Light tugging confirms that the Foley catheter is firmly in position. In case that the catheter is still shifting, more sterile water is added. In case this fails to work, the catheter may need to be replaced due to a leaking balloon. The entry site is dressed once the procedure is complete to discourage infection. Research suggests that the use of Foley catheters is preferable to the use of gastric tubes for enteral nutrition. One primary advantage offered by Foley catheters is their lower cost when compared to gastric tubes. The rate of failure of gastric tubes and Foley catheters is comparable with the rate of failure being slightly higher in gastric tubes (Kadakia, Cassaday, & Shaffer, 1994). Current research also suggests that Foley catheters can be utilized in place of gastric tubes for enteral