When I first fed a real patient via a nasogastric tube (NGT), I was feeling a little nervous and I even dropped one of the connecting tubes right at the start! It was quite embarrassing especially with a nurse staring at a clumsy me. Other times during lab practices, I "fed" at most 50ml of plain water. However, this time round, I had to feed 200ml of thicker fluid which flowed much much slower. Thus, the entire process was quite draggy. I lost concentration and as a result, forgot to kink the tube immediately when needed. Luckily, the enrolled nurse (EN) and a fellow nursing student saw it and alerted me! Thankfully, Mr K., my patient, did not cough and appeared fine/ normal. I made a mental note never to lose focus on my task at hand again.
The second time I fed Mr K., I was constantly reminding myself to remember to kink the tube. This time, with the experience of my first NGT feeding, everything was much better and the process was smoother-- I did not drop anything and I kept my eyes constantly on Mr K., his tube and my equipment.
I learnt that besides aspiration of fluid from the NGT to test for its acidity, there are two other methods of testing the placement of the tube. They are auscultation, the pumping of air into the tube and hearing its sound in the stomach and putting the tube into a cup of water to check for presence of any air bubbles, which may mean that the tube is displaced into the lungs. However, the best method to check for tube placement is to send patient for an X-ray. Having said that though, it is not feasible to send patient for an X-ray everytime the patient is about to be fed as there are not only manpower and costs issues, exposing patient to constant radiation, no matter how low, is harmful for the patient too. Thus, the most practical and reliable method is the aspiration method.
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