An orogastric (OG) tube is a flexible medical device passed through a patient’s mouth, down the throat and esophagus, and into the stomach. This tool is intended for temporary use and is always placed by a qualified healthcare professional. The tube itself is made of materials like polyvinyl chloride or polyurethane, which allows it to be both firm enough for insertion and soft enough to be tolerated inside the body. The tube’s design often includes features like a radio-opaque line, which allows it to be visible on an X-ray, ensuring it has been placed correctly.
Medical Uses for Orogastric Tubes
The primary applications for an orogastric tube are centered around providing substances to the stomach or removing them. One of the most common uses is for enteral feeding, also known as gavage feeding. This is necessary for patients who cannot swallow safely or are unconscious, such as premature infants or adults on mechanical ventilation, allowing them to receive liquid nutritional formula.
Another function is gastric decompression, which involves removing contents like fluid, air, or blood from the stomach. This procedure can relieve pressure and prevent vomiting in conditions like a bowel obstruction or after major surgery. In cases of drug overdose or ingestion of certain toxins, gastric lavage may be performed to wash out the stomach’s contents. Healthcare providers also use OG tubes to administer medications directly into the stomach when oral administration is not possible.
The Insertion Process
The insertion of an orogastric tube is a precise procedure performed by trained medical staff. The process begins with measuring the tube externally to determine the correct length needed to reach the stomach. This is estimated by measuring from the patient’s mouth to their earlobe and then down to the tip of their sternum, known as the xiphoid process.
Once the length is marked, the tip of the tube is lubricated to ease its passage and minimize discomfort. For a conscious patient, they may be asked to sit upright and swallow as the tube is gently guided through their mouth and down the esophagus. For patients who are intubated or unconscious, the clinician carefully advances the tube. After insertion, confirming the tube’s placement is a safety step. This can be done by injecting air through the tube while listening for gurgling sounds in the stomach, aspirating a small amount of stomach fluid, or, most definitively, through an X-ray.
Comparing Orogastric and Nasogastric Tubes
A common point of confusion is the difference between an orogastric tube and a nasogastric (NG) tube. The most apparent distinction is the insertion route; an OG tube is placed through the mouth, while an NG tube is inserted through a nostril. Though their functions are similar, the choice between them depends on the patient’s specific condition. For example, an OG tube is preferred for patients who are intubated or for premature infants because it leaves the nasal passages unobstructed for breathing.
Inserting an NG tube can be less invasive as the nasal passage may be less sensitive than the oral cavity for some patients. However, NG tubes can cause trauma to the nasal lining, leading to nosebleeds or sinusitis, risks that are avoided with an OG tube. A healthcare provider selects the type of tube based on the patient’s anatomy, the reason for the tube, and the anticipated duration of use.
Associated Risks and Patient Care
While beneficial, the use of an orogastric tube carries some risks. Patients may experience discomfort or gagging during the insertion process. There is also a risk of irritating the tissues in the mouth, throat, or esophagus. The most serious risk is misplacement, where the tube accidentally enters the trachea and lungs instead of the esophagus, which can lead to severe respiratory complications. These risks are minimized when an experienced professional performs the procedure and confirms placement.
Proper patient care helps manage these risks and ensure comfort. This includes maintaining regular oral hygiene to keep the mouth clean and prevent infections. Before each feeding or medication administration, the tube’s placement is re-checked. The tube is also securely taped to the side of the patient’s mouth to prevent it from moving or being accidentally dislodged. For patients receiving feedings, keeping the head of the bed elevated at 30 degrees or higher helps prevent stomach contents from flowing back into the esophagus, which can lead to aspiration into the lungs.