Ryles Nasogastric Tube
This is a narrow tube made of non-toxic, medical grade polyvinyl chloride (PVC) or polyurethane. The distal end is coned with steel balls sealed into the tube to facilitate easy insertion. Four lateral eyes along the distal end provide efficient drainage of secretions/fluids. The tubes are marked at 50, 60 and 70 cm from the distal end for accurate placement into the abdomen. The radio-opaque line provided throughout the tube helps radiographic visualisation. The proximal end is provided with a universal funnel connector for easy extension and allows a drain or feeding bag to be connected. Sizes available are 6–18F for adults and 10–14F for children. Ryles tubes are available in packs that have been pre-sterilised with ethylene oxide. They are also available individually in peelable pouch packs.
Nasogastric tubes are used for:
- aspiration in cases of intestinal obstruction and pyloric stenosis
- diagnosis of gastrointestinal haemorrhages and acute gastric dilatation
- enteral feeding and administration of drugs.
To insert a nasogastric tube, position the patient in the lateral position so as not to compress the oesophagus; alternatively, flex the neck in the supine position with pressure on the arytenoid cartilage. Different sizes of Ryles tubes should be kept ready, along with 2% lidocaine gel, sterile gloves and syringes. The nasogastric tube should be well lubricated and passed through one of the nostrils. Once it reaches the throat, the patient should be asked to swallow. The tube then easily enters the oesophagus and stomach. To check the patency of a Ryles tube, push 5–10 mL of air through it using a syringe. Auscultate with a stethoscope on the epigastric area below the xiphisternum or check radiographically to confirm the position. Fix the Ryles tube to the ala with tape.
Complications of nasogastric tubes include discomfort to the patient because of the tube, nasal bleed/epistaxis, damage to the nasal and oesophageal mucosa and gastric reflux, which may cause aspiration.
Ref: Bailey and Love 28th edition
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