Ryle’s Tube Care

A Ryle’s tube (NG tube) is a flexible tube inserted through the nose into the stomach for feeding, medication administration, or gastric decompression.

1. Indications for Ryle’s Tube

✔ Enteral feeding (unable to swallow, post-stroke)
✔ Gastric drainage (bowel obstruction, post-op ileus)
✔ Medication delivery (when oral intake is unsafe)
✔ Gastric lavage (poisoning, GI bleeding)

2. Equipment Needed for Insertion

• Ryle’s tube (size: 12–18 Fr for adults)
• Water-soluble lubricant (2% Lignocaine jelly)
• Syringe (50–60 mL) for aspiration check
• Stethoscope (for auscultation confirmation)
• Adhesive tape/securement device
• pH paper (to confirm gastric placement)

3. Step-by-Step Insertion

A. Preparation

1. Measure tube length (nose → earlobe → xiphoid process).
2. Lubricate tip (water-based jelly).
3. Position patient (upright at 45° if possible).

B. Insertion Technique

1. Insert via nostril (ask patient to swallow sips of water if conscious).
2. Advance gently until marked length is reached.
3. Confirm placement:

• Aspirate gastric contents (pH ≤5.5 = gastric).
• Auscultate (insufflate 20–30 mL air → “whoosh” sound).
• Chest X-ray (gold standard if doubt exists).

1. Secure tube (nasal tape or commercial holder).

4. Daily Care & Maintenance

✔ Flush with 30 mL water before/after feeds/meds.
✔ Check residual volume every 4–6 hrs (if for feeding):

• 500 mL? Hold feed, reassess.
  ✔ Oral/nasal hygiene (clean nostrils, mouth care).
  ✔ Change tube every 4–6 weeks (or per protocol).

5. Complications & Management