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Gastric Tube Insertion

Clinical Indications: Last update 02/2009

    Gastric decompression in intubated patients or for gastric decopression

Procedure:

    1. Estimate insertion length by superimposing the tube over the body from the nose, over the ear to the stomach.

    2. Flex the neck if not contraindicated to facilitate esophageal passage.

    3. Liberally lubricate the distal end of the tube with a water soluable gel and Hurricaine Spray. Then pass through the patient's nostril along the floor of the nasal passage. Do not orient the tip upward into the turbinates. This increases the difficulty of the insertion and may cause bleeding.

    4. In the setting of an unconscious, intubated patient or a patient with facial trauma, oral insertion of the tube may be considered or preferred.

    5. Continue to advance the tube gently until the appropriate distance is reached.

    6. Confirm placement by injecting 20cc of air and auscultate for the swish or bubbling of the air over the stomach. Additionally, aspirate gastric contents to confirm proper placement.

    7. Secure the tube.

    8. Decompress the stomach of air and food either by connecting the tube to suction or manually aspirating with the large catheter tip syringe.

    9. Document the procedure, time, and result (success) on/with the patient care report (PCR).

Competency Based Skill Requirements:

    Maintain knowledge of the indications, contraindications, technique, and possible complications of the procedure. Assessment of this knowledge may be accomplished via quality assurance mechanisms, classroom demonstrations, skills stations, or other mechanisms as deemed appropriate by the local EMS System.

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