Before an NG tube is inserted, it must be measured from the tip of the patient's nose, loop around their ear and then down to roughly 1-2 inch below the xiphoid process. The tube is then marked at this level to ensure that the tube has been inserted far enough into the patient's stomach. Many commercially available stomach and duodenal tubes have several standard depth markings, for example 18" (46 cm), 22" (56 cm), 26" (66 cm) and 30" (76 cm) from distal end; infant feeding tubes often come with 1 cm depth markings. The end of a plastic tube is lubricated (local anesthetic, such as 2% xylocaine gel, may be used; in addition, nasal vasoconstrictor and/or anesthetic spray may be applied before the insertion) and inserted into one of the patient's anterior nares. Treatment with 2.0 mg of IV midazolam greatly reduces patient stress. The tube should be directed straight towards the back of the patient as it moves through the nasal cavity and down into the throat. When the tube enters the oropharynx and glides down the posterior pharyngeal wall, the patient may gag; in this situation the patient, if awake and alert, is asked to mimic swallowing or is given some water to sip through a straw, and the tube continues to be inserted as the patient swallows. Once the tube is past the pharynx and enters the esophagus, it is easily inserted down into the stomach. The tube must then be secured in place to prevent it from moving. There are several ways to secure an NG placement. One method and the least invasive is tape. Tape is positioned and wrapped around the NG tube onto the patients nose to prevent dislodgement.