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Procedure of ryles tube insertion
1) To avoid cross infection wash your hands clean.
2) Collect the clean and sterile articles mentioned above.
3) Take all these articles to the right side of the patient.
4) Arrange them in such a manner that it will be comfortable for the patient and it will be convenient to work. It will save your time and energy.
5) Explain the procedure to the patient if he is conscious and relatives to gain their co-operation.
6) Put the curtain to provide privacy so that patient will not shy.
7) If the general condition of the patient permits, make him to sit on the chair, keeping his neck on the back of the chair, so that the portion of the neck will be extended which helps to insert the tube easily.
8) Place he mackintosh and towel around the neck to protect the clothes.
9) Help the doctor to pass the tube.
10) Clean the nostril with wet swabstick from which you are going to insert the tube.
11) Apply lubricant at the nozal part of the tube to avoid injury due to friction
12) While inserting the tube in the nostril, patient starts sneezing and coughing due to the stimulation of ciliated epithelial tissue. To avoid this tube should be passed gently but quickly
13) Keep the free end of the tube in the bowl containing water. If you observe the bubbles in the water, it indicates it is going in trachea to prevent the complications remove it immediately
14) When the tube reaches his throat ask him to do the swallowing action, because these movements make easy to go the tube inside the oesophagus.
15) After inserting the tube up to 18" to 20", confirm that the tube has reached in the stomach.
A) Ask the patient to open the mouth to confirm that it is not in the mouth
B) Confirm that the bubbles are absent while passing the tube.
C) Then aspirate with syringe, if gastric juice is aspirated then it is confirmed that the tube is in the stomach.
16) Then connect the glass funnel to the tube, hold the funnel with left hand by pinching the tube at the end of the funnel to prevent the air to enter in the tube. First pour the water, then pour the milk continuously before empting the funnel. If you want to use syringe then use only the barrel instead of funnel.
17) If it's the time of medicine, put it in the funnel and again pour the water to clean the tube from inside to avoid blockage.
18) After completion of the feeding remove the funnel, tight the clamp or fit the spigot. Stick it to the cheek or forehead of the patient with adhesive tape in such a manner that it will not create any obstacle in his sight.
19) Remove the mackintosh and towel, clean the face, make the patient comfortable. Do the bed neat and tidy, and then go to do the other work.
20) Record the date, time, nature and amount of the feed on the case paper
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