IRRIGATING A NASOGASTRIC TUBE CONNECTED TO SUCTION

1. Check physician’s order for irrigation. Explain procedure to patient.
2. Gather necessary equipment. Check expiration dates on irrigating saline solution and irrigation set.
3. Perform hand hygiene.
4. Assist patient to semi-Fowler’s position, unless contraindicated.
5. Check placement of nasogastric tube (see Skill 42-1, Action 14).
6. Pour irrigating solution into container. Draw up 30 mL of saline solution (or amount ordered by physician) into syringe. Don nonsterile gloves.
7. Clamp suction tubing near connection site. Disconnect tube from suction apparatus and lay on disposable pad or towel or hold both tubes upright in nondominant hand.
8. Place tip of syringe in tube. If Salem sump or double-lumen tube is used, make sure that syringe tip is placed in drainage port and not in air vent. Hold syringe upright and gently insert the irrigant (or allow solution to flow in by gravity, if agency or physician indicates). Do not force solution into tube.
9. If unable to irrigate tube, reposition patient and attempt irrigation again. Check with physician if repeated attempts to irrigate tube fail.
10. Withdraw or aspirate fluid into syringe. If no return, inject 20 cc of air and aspirate again.
11. Reconnect tube to suction. Observe movement of solution or drainage. Remove gloves.
12. Measure and record amount and description of irrigant and returned solution.
13. Raise equipment if it will be reused.
14. Perform hand hygiene.
15. Record irrigation procedure, description of drainage, and patient’s response.