Removing a Nasogastric Tube

Goal: The tube is removed with minimal discomfort to the patient, and the patient maintains an adequate nutritional intake.

1. Check medical order for removal of NG tube.

2. Perform hand hygiene and put on PPE, if indicated.

3. Identify the patient.

4. Explain the procedure to the patient and why this intervention is warranted. Describe that it will entail a quick few moments of discomfort. Perform key abdominal assessments as described above.

5. Pull the patient’s bedside curtain. Raise bed to a comfortable working position, usually elbow height of the caregiver (VISN 8, 2009). Assist the patient into a 30- to 45-degree position. Place towel or disposable pad across patient’s chest. Give tissues and emesis basin to patient.

6. Put on gloves. Discontinue suction and separate tube from suction. Unpin tube from patient’s gown and carefully remove adhesive tape from patient’s nose.

7. Check placement (as outlined in Skill 11-2) and attach syringe and flush with 10 mL of water or normal saline solution (optional) or clear with 30 to 50 mL of air.

8. Clamp tube with fingers by doubling tube on itself. Instruct patient to take a deep breath and hold it. Quickly and carefully remove tube while patient holds breath. Coil the tube in the disposable pad as you remove from the patient.

9. Dispose of tube per agency policy. Remove gloves and place in bag. Perform hand hygiene.

10. Offer mouth care to patient and facial tissue to blow nose. Lower the bed and assist the patient to a position of comfort as needed.

11. Remove equipment and raise side rail and lower bed.

12. Put on gloves and measure the amount of nasogastric drainage in the collection device and record on output flow record, subtracting irrigant fluids if necessary. Add solidifying agent to nasogastric drainage according to hospital policy.

13. Remove additional PPE, if used. Perform hand hygiene.