Changes

===Procedure===

===Procedure===

The horse should be adequately restrained in stocks or in the stable. The veterinarian may need a twitch or chemical restraint. The NGT should be immersed in the bucket of warm water to make it clean and flexible. Some veterinarians may lubricate the end of the NGT for a smoother, atraumatic passage. The veterinarian should stand on the horses left and place the right hand over the nose. The veterinarian's right thumb can be used to reflect the alar fold of the left nostril, without obstructing the airflow to the right nostril. The NGT is introduced ventrally into the ventral nasal meatus. The tube is advanced slowly and the veterinarian should not use force if there is resistance. Once the tube is at the level of the epiglottis in the pharynx, there may be some resistance. Most horses swallow the tube immediately, but if this is not the case then the veterinarian should carefully bump the epiglottis with the tube or blow down the tube. The tube may need to be rotated 180 degrees to pass down the esophagus.  

The horse should be adequately restrained in stocks or in the stable. The veterinarian may need a twitch or chemical restraint. The NGT should be immersed in the bucket of warm water to make it clean and flexible. Some veterinarians may lubricate the end of the NGT for a smoother, atraumatic passage. The veterinarian should stand on the horses left and place the right hand over the nose. The veterinarian's right thumb can be used to reflect the alar fold of the left nostril, without obstructing the airflow to the right nostril. The NGT is introduced ventrally into the ventral nasal meatus. The tube is advanced slowly and the veterinarian should not use force if there is resistance. Once the tube is at the level of the epiglottis in the pharynx, there may be some resistance. Most horses swallow the tube immediately, but if this is not the case then the veterinarian should carefully bump the epiglottis with the tube or blow down the tube. The tube may need to be rotated 180 degrees to pass down the esophagus.  

It is very important to check that the tube is in the esophagus and not in the trachea. The tube is visible passing down the left neckline when it is in the esophagus. It is not visible if it is in the trachea. There is negative pressure in the esophagus when suction is applied to the tube. There is no negative pressure in the trachea during suction. If the tube is in the esophagus, there should be some resistance its passage. There is no resistance when the tube is advanced down the trachea and the tracheal rings are palpable.  

It is very important to check that the tube is in the esophagus and not in the trachea. The tube is visible passing down the left neckline when it is in the esophagus. It is not visible if it is in the trachea. There is negative pressure in the esophagus when suction is applied to the tube. There is no negative pressure in the trachea during suction. If the tube is in the esophagus, there should be some resistance its passage. There is no resistance when the tube is advanced down the trachea and the tracheal rings are palpable.