Indication:

Gastric decompression is recommended for patients receiving positive pressure ventilation.

Precaution:

• Reduced level of consciousness without intubation
• Basilar skull fracture (Nasogastric placement is contraindicated)
• Oral and/or nasal obstruction
  

Procedure:

• Insertion
  • Measure from nose or mouth to earlobe then to xiphoid for approximate depth of insertion
  • Use a water soluble lubricant.   Viscous Lidocaine / Neosynephrine as necessary
  • Advance the tube.  Limit the tube depth to 5cm with each swallow in conscious patients
  • Remove the tube immediately if the patient develops difficulty breathing
  • Aspirate stomach contents and auscultate over the xiphoid to ensure correct placement
  • Secure with tape or tie
    

• Maintenance
  • Re-verify placement as necessary
  • Apply suction intermittently at lower settings (20-80 mmHg) or as ordered