Verify the prescription and patient identity
Explain the procedure briefly and obtain consent if required
Perform hand hygiene and wear gloves
Gather equipment: Ryle’s tube, lubricant, syringe, pH strips, tape or fixation device, stethoscope if used by local protocol, water if allowed, kidney tray
Position the patient upright if possible
Measure the tube from nose to earlobe to xiphoid process and mark the length
Inspect the nostrils and choose the more patent side
Lubricate the distal end of the tube
Ask the patient to tilt the head slightly forward
Gently insert the tube through the nostril along the floor of the nasal passage
Advance the tube slowly to the oropharynx
Ask the patient to swallow if able, and continue advancing during swallowing
Stop if the patient coughs severely, chokes, or shows respiratory distress
Advance the tube to the marked length
Confirm placement according to local protocol, preferably by aspirating gastric contents and checking pH
Secure the tube to the nose and cheek
Connect to the intended device or clamp the tube as ordered
Dispose of used items safely and perform hand hygiene
Document the procedure, tube size, insertion depth, and confirmation method used