Nasogastric intubation
Last reviewed: 23.04.2024
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[The procedure for nasogastric intubation
Several types of probes are used for intubation. Levin or Salem probes are used for gastric decompression or collection of contents for analysis and, rarely, for short-term feeding. Various long thin intestinal probes are used for prolonged enteral nutrition.
When probing, the patient sits upright or, if necessary, the examination is carried out lying on his side.
Irrigating the nasal mucous membrane and the local anesthetic with a local anesthetic reduces discomfort. The patient's head is slightly bent, the probe is injected into the nasal passage after treatment with the ointment agent and advances first backwards, and then downwards, respectively, in the nasopharynx. Since the tip of the probe reaches the pharyngeal wall, it is advisable that the patient sips water through a straw. A strong cough with air entering the probe during breathing indicates the location of the probe in the trachea. Aspiration of the gastric juice along the probe confirms its presence in the stomach. The position of the probe in the stomach can also be identified by inserting into the probe 20-30 ml of air with simultaneous auscultation by a stethoscope in the left hypochondrium, which detects the noise of the incoming air.
Thin and flexible intensional nourishing probes require the use of rigid conductors or stilettos. To carry out such probes through a pyloric channel, fluoroscopy or endoscopy is necessary.
Nasogastric intubation: contraindications
Contraindications to nasogastric intubation include nasopharyngeal or esophageal obstruction, severe maxillofacial trauma and uncorrectable hemocoagulation disorders. Varicose veins of the esophagus were initially attributed to contraindications, but there was no conclusive evidence of adverse effects.
Complications of nasogastric intubation
Complications of nasogastric intubation are rare and include nasopharyngeal injury of varying degrees with developing bleeding or without, pulmonary aspiration, esophagus or stomach injury with bleeding or perforation and (very rarely) intracranial or mediastinal penetration.