Nasogastric tube placement

(A) Lubricate the nasogastric (NG) tube and offer the patient a cup or glass of water with a straw (unless contraindicated). Place the tube into one of the nares, gently advance the tube but stop before it reaches the nasopharynx. Direct the patient to sip and swallow as the tube is advanced which helps pass the tube into the esophagus. If water is not being used, ask the patient to swallow.
(B) Once the tube is in place, aspirate using a suction tip syringe and examine the aspirate. It should have a typical gastric fluid appearance (grassy green, clear and colorless with mucus shreds, or brown). If needed, place a small amount on the pH test strip; the pH should be ≤5.0. Alternatively, instill about 15-20 cc warm water and then aspirate. If the tube is in good position, at least 1/2 of the fluid should be returned.
(C) Secure the NG tube to the patient's nose with hypoallergenic tape (or an NG tube holder). If the patient's skin is oily, wipe the bridge of the nose with an alcohol pad and allow to dry. Split one end of the tape up the center about 1 1/2 inches. Make tabs on the split ends (by folding the sticky sides together). Apply the unsplit tape end on the patient's nose so the split in the tape starts about 1/2 to 1 1/2 inches from the tip of the nose. Crisscross the tabbed ends around the tube. Apply another piece of tape over the bridge of the nose to secure the tube.