NGTD, or Nasogastric Tube Drainage, is a standard medical procedure used temporarily in hospital settings to manage the contents of a patient’s stomach. This non-surgical intervention uses a flexible tube to remove air and fluid from the upper gastrointestinal tract. NGTD allows the digestive system to rest, alleviating pressure from excessive buildup within the stomach and intestines, and manages various acute digestive health issues.
Understanding the Nasogastric Tube
The nasogastric tube, or NG tube, is a thin, pliable length of plastic material. This specialized catheter is gently threaded through the patient’s nostril, passing through the throat and esophagus until its tip rests inside the stomach. The tube’s size and type, such as a large-bore Salem sump tube, are selected based on the specific purpose, often preferred for effective suction and drainage.
Once the tube is in place, correct positioning must be confirmed before drainage begins, which is a paramount safety step. The most reliable method for confirming placement is an abdominal X-ray, which provides visual confirmation of the tube’s location. Another common technique involves aspirating fluid from the tube and testing its pH level; a measurement of 5.5 or less generally indicates proper gastric placement.
Primary Medical Uses for Drainage
The primary purpose of NGTD is gastric decompression, which is the relief of pressure within the stomach. This is necessary when the gastrointestinal tract is blocked or temporarily paralyzed, a condition known as ileus, often seen after major abdominal surgery. By continuously drawing out air, gas, and digestive secretions, the procedure prevents the stomach from becoming distended, reducing discomfort and lowering the risk of complications.
The tube is an effective intervention for acute bowel obstruction, where the passage of food and waste is hindered. NGTD is also employed in emergency situations to remove toxic substances or undigested material from the stomach. For instance, in cases of overdose or poisoning, the tube allows for gastric lavage, or “stomach pumping,” to quickly clear harmful contents before they are absorbed into the body.
Managing and Discontinuing the Tube
While the NG tube is in place, management focuses on maintaining its patency and minimizing discomfort. The tube must be secured to the nose with specialized tape to prevent accidental dislodgement, and the skin around the nostril is regularly inspected for irritation or pressure sores. Since the tube blocks one nasal passage and can lead to dry mouth and throat, frequent oral hygiene, such as mouth rinses, is necessary.
The tube is a temporary measure, and removal is planned once the underlying medical issue resolves. Before removal, a healthcare provider may conduct a “clamping trial,” where the tube is temporarily clamped shut for several hours. If the patient tolerates this trial without a return of nausea, vomiting, or abdominal swelling, it suggests that normal digestive function has returned. Removal is typically a swift process performed by a nurse, often involving the patient taking a deep breath and holding it to prevent aspiration during withdrawal.