اد ا/ ت ر ا
ا – ا ست ات ا ب
DR\ FUAD ALJABRI 6
3. Naso-intestinal (nasoenteric) tube: Is Anatomy of Gastrointestinal tract
the tube that Inserted via nose to 1. Oral cavity
2. Pharynx Functions of GIT:
intestine. 3. Esophagus To Provide body with:
4. Ostomy: Tube inserted surgically 4. Stomach Water
through the abdominal wall to stomach 5. Liver & pancreas
6. Small Intestine Electrolytes
or intestine such as (gastrostomy , or 7. Large Intestine Nutrients
jejunostomy , duodenostomy) . 8. Rectum
DR\ FUAD ALJABRI 7 DR\ FUAD ALJABRI 2
Gastrostomy feeding tubes.
DR\ FUAD ALJABRI 8
DR\ FUAD ALJABRI 3
Definition: is inserting of rubber
or plastic tube into the stomach or
intestinal through nose or mouth,
or abdominal wall, for feeding or
irrigating the stomach purposes. .
DR\ FUAD ALJABRI 9
DR\ FUAD ALJABRI 4
1. Gastric gavage: Tube used for feedings or 1. Nasogastric tube (NGT): Is the tube that
medications administration into the stomach for Inserted via the nose and passage
long time, this tube also called “feeding tube”. through oesophagus to stomach.
2. Gastric lavage: Tube used to remove gas and 2. Orogastric tube (OGT): Is the tube that
fluid or contents from the gastric (irrigation) or to Inserted via the mouth and passage
obtain a specimen of gastric for short time, this through oesophagus to stomach
tube also called “suction tube or Ryle’s tube”. usually used for remove poison.
DR\ FUAD ALJABRI 10 DR\ FUAD ALJABRI 5
FR
Gastric
(Salem)
Sump tube
DR\ FUAD ALJABRI 16 DR\ FUAD ALJABRI 11
NGT Purposes the tip.
is a single-lumen tube with holes near
1. To administer feedings and medications Made of plastic or rubber with Circular markings
when clients unable to eat or swallow on the tube serve as insertion guides.
Size: 14-18 French diameter, and 125 cm long.
orally. Connect to a drainage bag or suction device .
2. To washing the stomach from contents Used to remove gas and fluid from the upper GI
or poisoning or overdose of medications. tract or to obtain a specimen of gastric contents
(lavage).
3. To remove and treat gastric distention Sometimes used for medications or feedings
,nausea, and vomiting. administration (gavage).
DR\ FUAD ALJABRI 17 DR\ FUAD ALJABRI 12
4. To take specimen from the stomach
contents for laboratory analysis.
5. To promote healing after abdomen or
oral surgery.
6. To monitor and control of bleeding in
the gastrointestinal (GI) tract .
7. To help treat an intestinal obstruction.
DR\ FUAD ALJABRI 18 DR\ FUAD ALJABRI 13
Size of Ryle's tube NGT as age:
Newborn: 5 – 8 FR
Infants: 8 – 12 FR
Child: 12 – 14 FR
Adult: 16 – 24 FR
DR\ FUAD ALJABRI 19 DR\ FUAD ALJABRI 14
is a tube Made of Clear plastic
contain Double lumen with air vent port.
1.Nasogastric tube. 9.Lidocaine jelly 2%
The two lumens: one for removal of gastric contents
2.Suction tube. (Water-soluble lubricant) and one to provide an air vent which prevents
3.Urine bag. 10.Oral analgesic spray suctioning of gastric mucosa.
4.Drugs or nutrients. (Benzocaine spray) Sizes: 12-18 FR in diameter, and 120 cm long.
5.Adhesive Tape. 11.Glass of water with a This tube is preferable for stomach decompression.
6.Suction device . straw. Used to remove gas and fluid from the upper GI tract
7.Disposable gloves. 12.Funnel or feeding or to obtain a specimen of gastric contents.
8.Emesis basin . container (100-500ml). Also used for medications or feedings (gavage).
DR\ FUAD ALJABRI 20 DR\ FUAD ALJABRI 15
13.Container for waste. 22.Scissor and clamp.
14.Flashlight or pen light. 23.Normal saline solution
15.Stethoscope. (for irrigation only).
16.Paper Tissues 24.Syringe 10ml for lubricant.
17.Curtain. 25.Catheter syringe (20 -
18.Towel & Small pillow. 50ml).
19.Tongue depressor . 26.Laryngoscope.
Local spray Anesthetic 20.Pen marker. 27.Cup with water.
21.PH strips 28.Activated charcoal.
DR\ FUAD ALJABRI 26 DR\ FUAD ALJABRI 21
Procedures ج ء ت
. ر و ( سل ا د ن وج ا دوات
.واشرح ا جراء ه ( رف سك ر ض و رف
: س ا رض و (
high Fowler’s أوsitting : ا ر ض غ او ط ل وا
back position أوside lying : وا ر
semi-Fowler’s أوsemi lateral (sim’s : دان ا و
Left lateral position :س ل ا دة
DR\ FUAD ALJABRI 27 DR\ FUAD ALJABRI 22
Nasogastric tube
ل د ا ا س ( (Ryle's tube)
Catheter syringe
(syringe with catheter tip)
ل دة ن ا وب وصو
إ س ك ا وب و د ن رأ
ا ن إ شnostril ا ف
ثم د إ أس ل ظمear lobe
ث م،xyphoid process ا
م أو و
.ا ي دد ه ا
DR\ FUAD ALJABRI 28 DR\ FUAD ALJABRI 23
1 2
Tissue
paper
feeding bag
Urine bag
DR\ FUAD ALJABRI 29 DR\ FUAD ALJABRI 24
. ات ا ظ إر دي ا (
ن ا ف س دام ا وء أو ا ظ ر و د إ (
،ت أو ف أو إ ا ف ن أي ن و
ن ا ه و ثم أط ب ن ا ص ب ن سد أ د
.أو سدودة ر ن ا رى ر أي
صدر ا ر ض و ه و ا ش او (
. صدر ا ر ض ا وض ا وي
وا ل%2 دو ن ل ن ا جل ا وط10 (
ن ا إ ر أو و ن ا ء ا laryngoscope Activated PH strips
. ا در ا خ ا charcoal
DR\ FUAD ALJABRI 30 DR\ FUAD ALJABRI 25
ا م و د ن أن ا وب م وي دا ل ا م وأ ه (م Aspiration of viscous insert of viscous lidocaine 2%
ا وم إ ا ريء س دام ض ا س ن. د ر lidocaine into an oral syringe
دا ل ا وب د م واص م ا رض (
ك أو ك جب ا ددة ،وأث ء وصو ه
ق أو وجدت إ ر ن ا روري را وجه ا ر ض ن
إد ل وف ن دء ا ر ض س ل أو م س ط ا م
ا سن م وأن م ا وب ورا ب سن ا
ا وب.
DR\ FUAD ALJABRI 36 DR\ FUAD ALJABRI 31
د ن أن مدد ا ( د وصول ا وب إ ا ن (
: طوات ا ا وب ا دة و ك
سر ج ا سطرة ن ا واء ا طر ا و :إس ب
ا جل ا رطب
ط اط اس ا وب ثم وث ا اب ا ء
ا وب واس و م د ا واء و أس ل ظم ا ا طرف
ا دة ن س ت أصوات ر أو أصوات إ د ع ا واء ا دب ن
ن ا وب ال ا دة ،أ إ ا م س وب ر رة ا وب س
ول إد ل ا وب ا ص ا وا دا ن ا دة أو ن 7 – 5سم.
ن 5 – 3سم و رر ا جر . س
DR\ FUAD ALJABRI 37 DR\ FUAD ALJABRI 32
دة ص رة ت رأ ا ر ض س دة (
م وا س ل د دء إد ل ا وب. ا رأ
أص ك و ن و ث م اد ل ا وب ( م ف ا وب
س لو ل ج ون ا و ا ف
ا ن.
رأ ا ر ض دة وب م ( د وج ود و
ص طدم ه ص در و م ا ر ض ن م وا س ل
. ت ا ب أو أ طه ء أو ص ر شرب وم
DR\ FUAD ALJABRI 38 DR\ FUAD ALJABRI 33
:م و اث ا طر
ا وب ا سر ج
وراء ا ن واس ب ا
ا دة د ظ ر ا وب
ن أن و ت ن ا دة
ن لو د
دل ش رط
PHو ر ا ون ا و
ر . ور ا وان ا
DR\ FUAD ALJABRI 39
DR\ FUAD ALJABRI 34
وظ :
pH test
paper
with ن–5 إ ا ن ا وب ط ط جب و ه ث
color-coded
pH paper ،وإ ا ن ا وب ص ب 10د
. ن ء دا ئ و س
د د رد ل ر ض د إد ل ا وب ث ن
gag reflexو ك و ف ن إد ل ا وب
دأ ا ر ض ثم واصل ا د ل ا إس ر ا ث ن أو
ا ر ض م ا ا وب.
DR\ FUAD ALJABRI 40 DR\ FUAD ALJABRI 35
در شع ة ل
لط ة ل ل ة:
ل ح ه م
ل .
ب كن
ة: ة ل لط
ء ان ن ء ب ي
م ش ب ي ل د
ل ء ،إن ن ي ت
م ة ل ف ة ل
This NGT is in a normal position in the
ل ء ت
stomach. ة. ب د إز لة
DR\ FUAD ALJABRI 46
DR\ FUAD ALJABRI 41
The NGT is coiled up in the pharynx The tip of the NGT is in the right lower lobe
DR\ FUAD ALJABRI 47 DR\ FUAD ALJABRI 42
NGT is in the right lower lobe
DR\ FUAD ALJABRI 48 DR\ FUAD ALJABRI 43
وب دة م ث ت ا ( د ا د ن أن ا وب
م. ا ف شر ط ا ص
ل ض ت ل ي حدث . . جسو ل
أو س ر ج ث م أ ل ا وب أو وص ه ( م
. ة لغذ ء ل ي ط ص. ل
. د ظ ا دوات ،وأ د
ب ح .
د شث ء حل ة ل ن ا ر ب وأي تا (أ سل د ك ،ثم سجل ل ا
ب. لغ
. ل وو ردود د دثت أث ء ا ر ب وا ط ب ا
د ة ي ل ل ل
ل ر خ. ل ك.
. لغ
لط س و ل ت أو س ل ا دة س ب ا (إ دأ
ل ف ة ل ن
ق ل د. لي وعط
. اط با
DR\ FUAD ALJABRI 49 DR\ FUAD ALJABRI 44
ي ل د ب إج ء ت إز لة
وص ا ط ب و د ن أ ر إ ا ا وب. إ .
ات ظ – ش – ط ( إج ا دوات ا .
أو ء – وض وي – د ل ور – ول شر
ر . طر – س – ر ه – سر ج 10ل) ،ثم م
ات ا ظ . أ سل د ك وار دي ا .
صف هإ و اشرح ر ض ا جراء ،ثم دل و .
ا ج و أو ش ه صف ا ج و .
DR\ FUAD ALJABRI 50 DR\ FUAD ALJABRI 45
.صدر ا ر ض أو ا ش ا .
.وض ا وي إ ط ا ر ض ا د ل و ه أن سك.
1. Trauma to nasal, oropharynx and GIT. إ أو ء طر وأد ل ول10 م س ب.
2. Bleeding (Epistaxis). .) ل واء20 – 10 ( ا وب ظ ه أو
3. Atelectasis, pneumonia and lung abscess . .ر أ ل ا شر ط ا ص.
4. Bronchial perforation and pleural cavity . و س ه صدر م ا ر ض أن.
penetration (Pneumothorax , Empyema أو أث ا وب وأ ط ط ا شر ا وب م.
and Sepsis, Pulmonary haemorrhage). .طرف ا وب ه دك او ث ت ا سر ج
5. Intracranial penetration. .سه ا رض س أ ل ا وب ر و سر ه.
DR\ FUAD ALJABRI 56 DR\ FUAD ALJABRI 51
ثم، ا وض ا وي ت أو أر ا وب س ا.
. اس ات أر أ لا
. م ظ ف ا م وا ف ر ض أو د ه وم ك سه.
او إ دة ظ أ ل ل ا دوات ا س د ر.
. وط ر
وسجل ك،ر وأ سل د ك أ د ا ر ض و.
. سجل ا ر ض و ت وا ر وو
DR\ FUAD ALJABRI 52
1. Cerebral spinal fluid leak Racoon eyes
from nose/ ears.
2. Head trauma & Skull
fracture
3. Coagulopathy or systemic
Anticoagulants.
4. Seizure activity.
DR\ FUAD ALJABRI 53
5. Ingestion of corrosive
substances acids or
alkali
6. Esophagus bleeding or
stomach perforation,
recent surgery.
7. Nasal septal deviation
or fracture. Coagulopathy
DR\ FUAD ALJABRI 54
Nasal trauma Septal deviation
DR\ FUAD ALJABRI 55
