How to insert a nasogastric tube
Other platforms explain it with text and video. In Making Synapses you practice it on the patient.
An NG tube placed in the lung can kill. Placement must be confirmed before anything goes in.
Step by step
Explain and position
Sitting up, head slightly forward; check nostrils. [1]
Measure
Tip of the nose to earlobe to the xiphoid; mark the tube. [1]
Lubricate and insert
Along the floor of the nose, back and down. [1]
Swallow
Ask the patient to sip water and swallow as you advance. [1]
Stop if
Coughing, choking, color change or cannot talk: pull back. [1]
Confirm
Per policy, usually X-ray for feeding tubes, and pH of the aspirate. [1]
Secure and mark
Tape to the nose, mark the length at the nostril. [1]
Common errors
- Feeding before confirmation.
- Relying on air whoosh sound.
- Not marking the length.
Practice it in Making Synapses
In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
Making Synapses cases that train this skill
Sources
- Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
- OpenStax, Clinical Nursing Skills (reference)
Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Facts and steps also follow OpenStax, Clinical Nursing Skills (reference). Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.