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How to place a nasogastric tube in a patient | VetGirl Veterinary CE Videos

April 2014

*Note: This video has no sound, so no need to adjust your sound!*

This VetGirl video demonstrates how to place a nasoesophageal (NE) feeding tube in place. Note, this is more commonly done in cats than in dogs, and can easily be done without sedation. Local anesthesia should be used (e.g., 3-4 proparacaine drops into the nostril). The NE tube should be pre-measured to the last rib and marked appropriately (so we know how far in to insert the NE tube). With gentle but firm pressure, the NE tube should be inserted into the nostril with quick, short movements).

Once the tube is in place, it should be evaluated if it is in the correct location (e.g., the esophagus versus the trachea). Several techniques can be used to test the tube, including:

  • Aspirating gastric contents back
  • Flushing 5 mls of water into the tube and observing for coughing (versus licking)
  • Inflated air (e.g., 12-20 mls) quickly into the tube while simultaneously ausculting over the stomach and listening for inflation over the abdomen
  • Lateral radiograph, including the neck region, to ensure the NE tube is in the esophagus

Note: Blood doesn’t typically come out when aspirating, but it did in this case! We suspect this cat had some blood in it’s stomach. Fear not!

Once the tube is confirmed to be in place, it should be secured in place with a Chinese finger trap. An e-collar should always be in place while the NE tube is in place, to prevent accidental patient removal. Typically, enteral feeding can be started immediately, with 1/4 of the resting energy requirements (RER) started initially, and progressing to full RER within approximately 24-48 hours.

    • As noted in the text directly below the video, “*Note: This video has no sound, so no need to adjust your sound!*”

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