Place the patient in a head-down, left side-lying position to reduce the risk of aspiration if the patient vomits. Apply a water-soluble lubricant to the first 4 inches of the distal end of the tube. Insert the tube orally or nasally as indicated by the provider’s orders. Ask the patient to swallow, then advance the tube until you have inserted the appropriate length of tubing. Do not use force to pass the tube, especially if the patient is struggling. Inspect the back of the patient’s throat using a penlight and a tongue blade to ensure that the tube has not coiled. Temporarily secure the oro- or nasogastric tube. Ideally, proper tube placement is confirmed radiographically. If this is not possible, aspirate gastric contents and test the pH of the aspirate. Once you have confirmed appropriate placement, secure the tube. If gastric samples are required for analysis, aspirate gastric contents and place the aspirate in a specimen container.
Connect the lavage tubing to the patient’s gastric tube. Open the clamp to the irrigant solution and assess the patient’s vital signs, respiratory status, and level of consciousness. For an adult, use 200 to 300 mL, preferably of warm (100.4°F [38°C]) fluid, such as normal saline or water. For a child, use 10 mL/kg of warm normal saline (not water because of the risk of inducing hyponatremia and water intoxication in young children). After the specified amount infuses, aspirate gastric contents by clamping the irrigant solution’s tubing and