Introduction
Nasogastric (NG) aspiration involves the insertion of a wide-bore NG tube into the stomach to remove gastric contents. It is primarily used for decompression, diagnostic sampling, or therapeutic drainage in adults with gastrointestinal conditions.
Definition
Gastric aspiration is a therapeutic method of removal of gastric contents from the stomach
Purposes
- To remove fluid or gas in case of abdominal distension, paralytic ileus, or intestinal obstruction.
- To prepare the patient for surgery.
- To remove irritants from the gastrointestinal tract.
- To treat bleeding from esophageal varices.
- To aid wound healing after gastrointestinal surgeries.
Indications
- Before surgery.
- Ingestion of any poisonous agents, for example, pesticides.
- Loss of anatomical integrity of upper and lower esophageal sphincters.
- Before NG feeding.
- Gastric immobility and bowel obstruction.
- Overdose of drugs.
Contraindications
- Corrosive poisoning (increases the risk of perforation of the esophagus).
- Ingestion of sharp objects.
- Seizure.
- Patient at risk of GI bleeding due to any pathology or surgery.
Articles
Preparation of Articles
| Articles | Purpose |
| Gastrointestinal tube | To insert and aspirate. |
| Lubricant jelly | Facilitates insertion of tube easily. |
| Stethoscope | To confirm tube placement. |
| 20-mL syringe (plastic) | To aspirate gastric contents. |
| Gauze pieces | To keep under free end of the tube. |
| Water in a bowl | To check tube placement, and rinse syringe. |
| Mackintosh with towel | To protect the linen from soiling. |
| Drainage collection bag or bottle | To collect gastric contents. |
| Clean gloves | To minimize transmission of organism. |
| Kidney tray | To collect waste. |
| Litmus paper | To check acidic nature of secretions. |
| Adhesive | To secure tube. |
Procedure
| Nursing Action | Rationale | |
| 1. | Check the doctor’s order. | Confirm the procedure. |
| 2. | Explain the procedure and purpose to the patient. Obtain consent from the patient. | To alleviate anxiety and gain cooperation of the patient. To prevent litigation of staff members. |
| 3. | Arrange the articles at the patient’s bedside. Provide privacy. | To avoid wastage of time. To maintain dignity of the patient. |
| 4. | Wash hands and don gloves. | To prevent cross-infection. |
| 5. | Place the patient in Fowler’s position or elevate head of the bed to 30°. | Prevents the chance of aspiration. |
| 6. | Place towel with Mackintosh over the patient’s chest. | Prevents bed from soiling. |
| 7. | Check for the placement of the tube. | To confirm the position of tube. |
| 8. | Keep gauze piece under the free end of tube. | To prevent spilling. |
| 9. | Pinch the tube at the proximal end and fix the syringe to free the end of the tube, release and start aspirating. | To prevent air entrance in the stomach. To aspirate content. |
| 10. | Collect the content in collecting bag. | For approximate measurement and further examination of content. |
| 11. | Repeat aspiration until contents are completely removed or negative pressure is felt. | Ensure that stomach contents are removed. |
| 12. | Replace articles and document date and time, amount, color, consistency of drainage, and patient’s condition. | Maintain proper intake/output record. |
Monitoring & Documentation
- Record insertion time, tube size, confirmation method, and patient tolerance
- Monitor for signs of aspiration: coughing, desaturation, respiratory distress
- Document aspirate characteristics and volume
- Reassess tube position regularly, especially after vomiting or coughing episodes
Special Considerations
- Never use the tube for feeding or medication until placement is confirmed
- Misplacement into the respiratory tract is a “Never Event” and must be avoided
- Use radiopaque tubes with external markings for safety compliance
- Avoid insertion in patients with basilar skull fractures, recent nasal surgery, or severe coagulopathy
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
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