Swallowing NG Tubes: Tips n’ Tricks to Make it Easier.
I wanted to start off with this video of me swallowing an NG tube a few months ago while I was in the hospital. As you can see in the video I was calm, cool, and collected; something I wasn’t in the past when it came to swallowing tubes. NG tubes used to be a HUGE source of anxiety for me and that’s putting it lightly. In the video I am swallowing a pediatric size tube (one of the tips I’ll share with you in a moment), but I’ve also swallowed my fair share of the larger NG tubes as well.
Like this one!
So how did I go from one extreme, where the very thought of an NG tube had me extremely anxious and upset, to the calm person in the video who can swallow a tube like a boss?
I suppose experience has something to do with it. I’ve swallowed a lot of tubes! 4 this year already. Naturally I’ve learned some tricks that have made swallowing an NG tube or NJ tube a lot easier on me and I wanted to share them with you.
Tips to Make Swallowing NG Tubes Much Easier:
Frame of Mind: This tip is the thing that has helped me the most and it is to put myself in a calm, ‘I can do this,’ frame of mind. Easier said than done, I know, and if someone told me this years ago I would have never thought I’d be able to do it. Basically I give myself a mental pep talk. I convince myself that I can do this! It’s no big deal! It’ll all be over before I know it. I try not to think about what’s happening, try to relax, basically anything to not freak out.
In the past I would freak out with anxiety and I learned it made the whole process SO much worse and it took a lot longer. I used to be so afraid and worked up that I would start crying and hyperventilating which only made getting the tube down more difficult. So I started to go at it with a different approach. It takes practice and I really had to work on this, but I got there and hopefully you will be able to as well.
Tube size: In the past I was always given the standard adult size NG tube they use for decompression. Then one day I was given the option of having a pediatric sized tube inserted and my mind was blown! Ever since then every time I need an NG tube I always request a pediatric sized tube because they are smaller and no one has ever said no. Usually the nurses and doctors want the insertion to go smoothly as well so they are willing to do what they can to help it along. It doesn’t hurt to ask!
Lidocaine Gel: Ask your doctor about snorting lidocaine gel up your nostrils. Sniff hard so that it drains down the back of your throat. Make sure they wait at least 5 minutes before inserting the tube so that the gel has time to numb the area. Studies have shown that lidocaine gel significantly reduces pain and gagging sensations when inserting an NG tube.
Anxiety Control: If you have severe anxiety at the idea of having an NG tube inserted you may want to ask for anxiety medication. You wouldn’t believe it now, but like I said I used to have extremely severe anxiety over having to have an NG tube inserted. During one of my hospital admissions the doctor ordered IV Ativan for me to have prior to getting the tube inserted. I didn’t ask for this, but it was nice of him to do that and it made things a bit easier. After that, I did ask for it a couple more times during tube insertions and was able to have it. You never know what they will say, but it doesn’t hurt to ask for help if you feel like you need it. Having to insert an NG tube on a patient with anxiety is difficult for everyone, so usually they will do whatever makes it easier.
Head placement: Right before they insert the tube look down, putting your chin to your chest and keep it there while they insert the tube. This head position makes the tube easiest to go down.
Water and a Straw: Ask for a cup of water with a straw. The straw is a must! I used to think this was standard practice, but lately I haven’t been given these things so I had to ask for them. Ask for them if you are not given them because this is key to getting the tube down nicely. Remember you will be looking down (chin to chest) so hold the cup, or have someone else hold it, where you can easily start sipping water through the straw while the tube is going down.
Swallow, swallow, swallow! As soon as the tube is inserted through the nose it will quickly reach the back of the nasopharynx and this is when you will want to start swallowing. Usually your body can tell when it wants to swallow, but the nurses are typically pretty good about telling you when to. Remember your ‘I can do this’ frame of mind and do not focus on anything else but sipping water. I never think about what is happening and all I do is concentrate on continuously sipping water. I try to relax envisioning myself sipping a tasty drink on the beach. The swallowing action helps push the tube down and before you know it it’s in! The video above shows that the whole process of getting that tube down took about 30 seconds.
So those are my tips. I do not mean to trivialize the process of having to have an NG tube inserted. It can be an awful experience and I’ve had my fair share of those but I did learn some things that can make it more manageable. This took me a lot of time and practice and I hope that some of the things that have helped me will be able to help you too!