Nasogastric (NG) Tube Insertion

Read the illustrated guide to nasogastric tubes on ClinicalSkills.net here: 

You will need to be logged into ClinicalSkills.net to use these pages: Go to ClinicalSkills.net, click login at the top, enter your user name and password. You must have set up your account to do this. For further information on how to login to your ClinicalSkills.net account please click here: How to Login to ClinicalSkills.net

Nasogastric Tube Insertion 

If you'd like to read more about administering feed via an enteral feed pump you might also find the following page helpful:

Administering Feed via Enteral Feed Pump 

Click on the button below to navigate to the 'Take a Test' area of ClinicalSkills.net. Please make sure you're logged into ClinicalSkills.net already, otherwise you may not be able to open and take the test. Once you have reached the 'Take a Test' area, select 'Local Tests' and then click on the test called 'Nasogastric (NG) Tube Insertion' to begin. You will need to score 80% or more to pass. Make sure you've read the ClinicalSkills.net procedure thoroughly before taking the test as many of the answers will be found within there!

This resource is the Geeky Medics website and contains a step by step guide to insertion and aspiration of a NG tube. This is supported with images and descriptions of the procedure as well as an interactive checklist to support you in ensuring all steps are complete.

Geeky Medics NG insertion OSCE guide 

This resource is the Patient Safety Alert issued by NHS Improvement in 2016, which outlines the continuing risk of harm or death caused by misplacement of an NG tube and asked organisations to undertake certain actions around this to reduce this risk.

NHS Improvement - Patient Safety Alert: Nasogastric tube misplacement: continuing risk of death and severe harm 

These resources support the 2016 NHS Improvement Patient Safety Alert: ‘Nasogastric tube misplacement: risk of death and severe harm through failure to implement previous guidance’, which required required NHS Trusts to examine how previous guidance on nasogastric tubes has been implemented and embedded in their organisations. 

NHS Improvement - Initial Placement Checks for NG Tubes 

Here is another guide to undertaking a nasogastric tube insertion. The Oxford Handbook of Clinical Skills in Adult Nursing give a guide to completing various practical skills which may be encounter through nursing practice. The handbook give a concise run through of each skill and how to perform these. For NG insertion please start at page 430. Please note that this is an e-book available via the library and you may need to log in using your SHU login and password.

Oxford Handbook of Clinical Skills in Adult Nursing

This historical (but still relevant) 2011 National Patient Safety Agency Patient Safety Alert outlines how staff can prevent harm due to misplacement of NG tubes. 

National Patient Safety Agency - Reducing the harm caused by misplaced nasogastric feeding tubes in adults, children and infants

This historical (but still relevant) 2012 National Patient Safety Agency Rapid Response Report outlines guidance to prevent harm from flushing NG tubes before confirming their placement in the stomach (as opposed to the lungs)

National Patient Safety Agency - Harm from flushing of nasogastric tubes before confirmation of placement  

This additional alert from 2013 confirms that tube position checks must still be done, even if a device is used to aid the placement of the NG tube. 

NHS England Patient Safety Alert - Placement devices for nasogastric tube insertion DO NOT replace initial position checks 

This website has a step by step guide to the insertion of NG tubes and how to confirm their positioning once inserted. There is also a quiz available to allow you to check your knowledge and understanding. 

Oxford Medical Education - Inserting NG tubes and confirming position

The Royal Marsden Manual of Clinical Nursing Procedures is a text giving guidance and information on a wide range of clinical skills and procedures including step by step guidance with associated images and text. 

Royal Marsden Manual of Clinical Nursing Procedures (9th Edition): Insertion of Nasogastric tube- Page 4-7 & 149-156

ProQuest Ebook Central - Reader 

(Page updated September 2023 Kate Heaton-Stockton)

Date reviewed: September 2023

Next review: September 2024