Standards Procedure (Skill)
Clinical Indications: Level: EMT-P only
Ř Gastric decompression in intubated patients or for administration of activated charcoal in patients with an altered mental status.
Procedure:
a. Estimate insertion length by superimposing the tube over the body from the nose and then around the ear to end at the xyphoid process
b. Flex the neck if not contraindicated to facilitate esophageal passage.
c. Liberally lubricate the distal end of the tube and pass through the patient’s nostril along the floor of the nasal passage. Do not insert upwards into the turbinates, this may cause bleeding and/or make insertion difficult.
d. In the setting of an unconscious intubated patient or a patient with facial trauma, oral insertion may be considered or preferred.
e. Continue to advance the tube gently until the predetermined measured distance is reached. (If the patient is conscious, have them swallow during insertion.)
f. Confirm placement by injecting 20cc of air and auscultate for the “swish” or bubbling of air over the stomach. Aspiration of gastric contents also confirms placement.
g. Secure the tube.
h. Decompress the stomach of air and food either by connecting the tube to the suction or manually aspirating with the large catheter tip syringe.
i. Document the procedure, time and patient response on the ACR.
Certification Requirements:
Successfully complete an annual skill evaluation including the indications, contraindications, technique, and possible complications of the procedure.