Adult Nasogastric Tube
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Minutes
Evaluator
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Student
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Skill Steps
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Verbalizes/demonstrates appropriate infection control precautions
Gathers and prepares equipment
Measures tube
Lubricates tube
Inserts tube to desired depth
Confirms tube placement via auscultation
Secures tube
Critical Criteria
Failure to take or verbalize appropriate PPE precautions
Failure to measure NG tube
Failure to assure proper tube placement by auscultation
Insertion or use of any adjunct in a manner dangerous to the patient
Failure to demonstrate the ability to manage the patient as a minimally competent EMT
Exhibits unacceptable affect with patient or other personnel
Uses or orders a dangerous or inappropriate intervention
Evaluator Comments
Success?
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Pass
Needs Remediation
Signature
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