NGT or OGT (nasogastric tube or orogastric tube) passes
through the nose, past the throat, and down into the stomach where she orogastric pass from mouth.
are used for providing nutrition
administration of medications, gastric decompression,
gastric irrigation
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through the nose, past the throat, and down into the stomach where she orogastric pass from mouth.
are used for providing nutrition
administration of medications, gastric decompression,
gastric irrigation
#nursing_intern
youtu.be
هذا هالفيديو يشرح طريقه الإدخال مع تحضير الأدوات in adult
هذا هالفيديو يشرح طريقه الإدخال مع تحضير الأدوات in adult
Nasogastric tubes come in various sizes (5,6,8, 10, 12, 14, 16 and 18Fr).
Smallest used with babies
Smallest used with babies
Nasogastric tubes are inserted by nurses, It is vital that staff inserting them know the correct insertion technique as well as the procedure for verifying their correct positioning.
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External measurement from the tip of the nose to a point halfway between the xiphoid and the umbilicus distance gives a rough idea of the required length.
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There is plethora search and Some of the important aspects to increase safety in using GT in newborns involve care in measuring the insertion length, assessing placement/positioning of the distal end of the tube, and in maintaining its correct positioning.
بامكاني اكتب الخلاصه االطريقه المفضله بس احنا كممرضيين لازم نقرا الافيدنس وليش هم طلعو بهالخلاصه.. فعلى سبيل المثال
The methods described in the literature use of the NEX and NEMU NEX (Nose, Earlobe, Xiphoid) , while NEMU (Nose, Earlobe, Mid-Umbilicus)
وف طرق آخر.. تابعو
The methods described in the literature use of the NEX and NEMU NEX (Nose, Earlobe, Xiphoid) , while NEMU (Nose, Earlobe, Mid-Umbilicus)
وف طرق آخر.. تابعو
minimum insertion length of the tube for low birth weight newborns (<1500g) .
13cm for newborns weighing less than 750g, 15cm for newborns weighing between 750 and 999g, 16cm for newborns weighing between 1,000 and 1,249g, and 17cm for those weighing between 1,250 and 1,499g.
13cm for newborns weighing less than 750g, 15cm for newborns weighing between 750 and 999g, 16cm for newborns weighing between 1,000 and 1,249g, and 17cm for those weighing between 1,250 and 1,499g.
طريقه اخرى استخدم الوزن
Orogastric:-3x[weight in kg]+12) and nasogastric tubes (3x[weight in kg]+13)
لكن الدراسات اثبت هذه الطرق accuracy مختلفه.. لذلك طلعو بخلاصه انه الأفضل الطريقه الي توضحها الصوره
Orogastric:-3x[weight in kg]+12) and nasogastric tubes (3x[weight in kg]+13)
لكن الدراسات اثبت هذه الطرق accuracy مختلفه.. لذلك طلعو بخلاصه انه الأفضل الطريقه الي توضحها الصوره
![طريقه اخرى استخدم الوزن
Orogastric:-3x[weight in kg]+12) and nasogastric tubes (3x[weight in kg]+13)...](https://pbs.twimg.com/media/DvFCPRMWsAABJiK.jpg)
بعد ما عملت إدخال التيوب لازم تعمل تأكيد انه التيوب في مكانه الصحيح.. لذلك في عدد من الطرق المتبعه:
X-ray
observation for presence of bubbling
auscultation with insufflation of air
litmus paper test
pH paper test
وايضا فيه كثير من الدراسات الا درست مدى فاعليه كل طريقه...تابعو
X-ray
observation for presence of bubbling
auscultation with insufflation of air
litmus paper test
pH paper test
وايضا فيه كثير من الدراسات الا درست مدى فاعليه كل طريقه...تابعو
First X-ray is currently the gold standard for NGT placement confirmation because they can visualize the course of the NGT.
However, it is infeasible, unsafe, and not cost effective to perform an X-ray and expose the patient to radiation before each NGT use.
However, it is infeasible, unsafe, and not cost effective to perform an X-ray and expose the patient to radiation before each NGT use.
الطريقه الثانيه ع حسب نسبه المصداقيه فيهن
pH testing
This is the first-line method recommended for NGT placement confirmation
لاحظو gastric pH usually falls within 1–5, while intestinal or respiratory pH is ≥7
لذلك aspirates with pH ≤ 5 would likely indicate gastric placement
pH testing
This is the first-line method recommended for NGT placement confirmation
لاحظو gastric pH usually falls within 1–5, while intestinal or respiratory pH is ≥7
لذلك aspirates with pH ≤ 5 would likely indicate gastric placement
لكن حتى Ph لها عيوب
_obtaining an aspirate is not always possible.
_presence of other factors which alter gastric pH such as medications
_obtaining an aspirate is not always possible.
_presence of other factors which alter gastric pH such as medications
هذه ph paper تجي ع أشكال مختلفه
.. البقيه بكره بكملهم ان شاء الله
.. البقيه بكره بكملهم ان شاء الله
راح نعمل NGT PLACEMENT CONFIRMATION
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3-Auscultation with insufflation of air
وهذه الطريقه متبعه في القسم الا اشتغل فيه وتكون عن طريق وضع stethoscope فوق منطقه epigastrium لسماع صوت الهواء المضغوط تقريبا ١٠ إلى ٣٠ ملي في الكبار ٠.٥ ملي للاطفال من فتحه NGT
تابعو الافيدنس ونظرته لهالطريقه
وهذه الطريقه متبعه في القسم الا اشتغل فيه وتكون عن طريق وضع stethoscope فوق منطقه epigastrium لسماع صوت الهواء المضغوط تقريبا ١٠ إلى ٣٠ ملي في الكبار ٠.٥ ملي للاطفال من فتحه NGT
تابعو الافيدنس ونظرته لهالطريقه
Evidence state that sounds may be transmitted to the epigastrium whether the tube is positioned in the lung, esophagus, stomach, duodenum, or proximal jejunum.
تابعو
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تابعو
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In three case studies the NGTs were thought to be in the stomach following air insufflation, they were in the lung, causing death in two out of three patients. In another study, 15 out of 16 NGTs were incorrectly identified as being in the stomach when auscultation method was use
Although auscultation lacks evidence, its advantage is that NGT aspirates are not required. Therefore, it is still used at the bedside, in the absence of an aspirate.رغم كذا ما زلنا نستخدمها لعدم توفر الطرق الأخرى.. بس الحمدلله لحد الان ما صارت اي incident
4-Litmus paper
if a blue litmus paper turned pink upon contact with aspirates, it would indicate an acidic aspirate suggesting a gastric placement.However, blue litmus paper turns pink even when pH is 6 or 7, a pH level that is unable to distinguish between gastric or bronchial
if a blue litmus paper turned pink upon contact with aspirates, it would indicate an acidic aspirate suggesting a gastric placement.However, blue litmus paper turns pink even when pH is 6 or 7, a pH level that is unable to distinguish between gastric or bronchial
5-Observation of bubbles
Observing for bubbles when the end of the NGT is in water assumes that if the NGT is in the respiratory tract, bubbling will occur upon exhalation.
Observing for bubbles when the end of the NGT is in water assumes that if the NGT is in the respiratory tract, bubbling will occur upon exhalation.
لكن الاشكاليه بهالطريقه
There were instances where bubbling did not occur when tubes were in the lung because the ports were occluded by pulmonary tissue
the stomach can contain gas hence bubbling may occur even if it were positioned correctly making it difficult for differente
There were instances where bubbling did not occur when tubes were in the lung because the ports were occluded by pulmonary tissue
the stomach can contain gas hence bubbling may occur even if it were positioned correctly making it difficult for differente
Finally I can say much progress has been made in the area of NGT placement confirmation over the years. However, a perfect method has yet to be found.
So we need new reliable methods and how research
Thanks
#nursing_intern
So we need new reliable methods and how research
Thanks
#nursing_intern
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