Indications for Nasogastric Tube Insertion To decompress the stomach and gastrointestinal (GI) tract (ie, to relieve distention due to obstruction, ileus, or atony) To empty the stomach, for example, in patients who are intubated to prevent aspiration or in patients with GI bleeding to remove blood and clots To obtain a sample of gastric contents to assess bleeding, volume, or acid content To remove ingested toxins (rare) To give antidotes such as activated charcoal To give oral radiopaque contrast agents To provide feeding of nutrients into stomach or feeding directly into small intestine with a long, thin, flexible enteral feeding tube Contraindications to Nasogastric Tube Insertion Absolute contraindications Severe maxillofacial trauma Nasopharyngeal or esophageal obstruction Esophageal abnormalities, such as recent caustic ingestions, diverticula, or stricture, because of a high risk of esophageal perforation Relative contraindications Uncorrected coagulation abnormalities Very recent esophageal intervention, such as esophageal banding (discuss with patient's GI health care practitioner before attempting to place) Complications of Nasogastric Tube Insertion Nasopharyngeal trauma with or without hemorrhage Sinusitis and sore throat Pulmonary aspiration Traumatic esophageal or gastric hemorrhage or perforation Intracranial or mediastinal penetration (very rare) Equipment for Nasogastric Tube Insertion Protective gown, gloves, and face shield Nasogastric tube for decompression such as a Levin tube (single lumen) or Salem sump tube (double lumen such that second lumen vents to atmosphere) If small intestine feeding planned, a long, thin, intestinal feeding tube (nasoenteric tube) for long-term enteral feeding (use with a stiffening wire or stylet) Topical anesthetic spray such as benzocaine or lidocaine Vasoconstrictor spray such as phenylephrine or oxymetazoline Cup of water and straw 60-mL catheter-tipped syringe Lubricant Emesis basin Towel or blue pad Stethoscope Tape and benzoin Suction (wall or mobile device) Additional Considerations for Nasogastric Tube When placing a smaller, more flexible intestinal feeding tube, a wire or stylet is used to stiffen the tube.