(c) Do not use an oil-base lubricant. The possibility of lipoid (fat)
aspirational pneumonia is to be avoided.
(d) If you encounter a severe resistance, withdraw the tube and
insert it in the other nostril.
(e)
Do not forcibly push it because you could injure tissues and
(8)
Have the patient drop his head forward and begin to swallow as the
tube reaches the back of the throat.
(a) Tell the patient to bend his head forward and (if permitted) to
swallow sips of water as the tube is passed down the esophagus to the stomach.
(b) Check the position of the tube as it passes down the back of
the patient's throat by having the patient open his mouth. Hold down the patient's
tongue with a tongue depressor.
(c) Withdraw the tube into the nose and begin again by having the
patient bend head forward and swallow; restart if the tube is coiled up in his mouth.
(d) Avoid long waits (long delays can increase the patient's
anxiety/discomfort). However, the patient can signal you to stop for a moment to rest, if
necessary.
(9)
Advance the tube each time the patient swallows or sucks air. See
Figure 4-4.
(a) If permitted, continue to have the patient swallow water or ice.
This helps as the tube is passed.
(b) The esophageal peristalsis and the fact that you work in a
reassuring manner will help the patient tolerate the procedure.
MD0915
4-12