If patient is conscious or old enough to follow instructions, instruct the patient to swallow to facilitate the placement of the tube in the stomach. Continue advancing tube until tape mark is at the nostril or the lip. If tube meets resistance or the patient has respiratory distress, remove the tube. Fogging of the tube accompanied by cough or respiratory distress indicates tracheal intubation. If patient begins to vomit, suction around tube and leave in place.
Auscultate lung sounds.
Reinsert following the same procedure. Tape in place or apply a tube holder. Instilling 20 to 150 ml boluses of solution to maximum of 4 liters. Then withdrawing same amount of fluid instilled. Repeat procedure until stomach contents return clear or until maximum volume has been reached.