Feeding Tube Care

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  • Nasogastric (NG) tubes (and sometimes orogastric tubes) are inserted when the patient cannot eat or swallow. The tube goes directly from the nose (nasogastric tube) or the mouth (orogastric gubes) directly to the stomach. Once this tube is in place, it can be used to give food and medicine. It can also be used to remove things from the stomach, such as toxic substances or a sample of stomach contents.
  • NG is most commonly used for patients who have facial or neck injuries or surgeries, have a mechanical ventilator, have an intestinal obstruction or blockage, are comatose, or are at risk for choking on foods due to difficulty swallowing.
  • Feeding：
    1. Elevate the head of the bed so the patient is in a semi-upright position. Stay in this position for 1 hour after feeding.
    2. If the patient needs chest percussion, sputum aspiration or repositioning, please do these 1 hour prior to feeding.
    3. Wash your hands with soap and water.
    4. Have the feeding syringe, liquid food and warm boiled water ready and close at hand. The temperature of the feeding material should be close to body temperature.
    5. Check that the NG tube is in the correct position before beginning feeding: with the feeding syringe connected to the NG tube, slightly withdraw the plunger so that you see some gastric content run into the tube.
    6. Check patient’s digestion status：
      • The amount of residual food in the stomach should be less than 50mL when digestion is adequate. If more than 50mL remain in the stomach, you may readminister the withdrawn stomach material as long as the material is still in the tube or the syringe. There is no need to withdraw all the material in the stomach and do not readminister material that has been drained into a different vessel.
      • Deduct the approximate amount still remaining in the patient’s stomach from the coming feeding. For example, if 60mL of undigested material has been drawn but the next meal is 300mL, give 240mL or less for the next meal.
    7. Detach the syringe from the feeding tube and remove the plunger in the syringe. Clamp the tube with your fingers then open the tube plug.
    8. Attach the syringe to the tube. Carefully fill feeding formula into the syringe. Hold syringe higher than the tube and unclamp your fingers. Allow formula to run by gravity. Try not to let the syringe get empty before refilling it, as air will enter the stomach.
    9. When finished, flush the tube with the prescribed amount of warm preboiled water. Manually clamp the tube then disconnect the syringe and recap feeding tube plug.
  • Feed every 2-4 hours of approximately 200-400mL. Gradually increase the amount if necessary up to 500mL per meal. Do not force-feed.
  • Always reclamp the feeding tube plug before removing the feeding syringe to avoid leakage.
  • Flush the tube with 30~60mL of water after each feeding or taking medications, or as often as your nurse recommends.
  • Each meal should take at least 15 minutes to give a feed. Feed slowly to and allow digestion and gravity to work at its own pace. Force feeding or rushing might cause air bubbles to enter the stomach which may result in nausea and vomiting.
  • Extra drinks (boiled warm water, tea, fruit juice) can be fed between meals.
  • Feeding material is not limited to formula. Milk, juice, soy milk, vegetable juice, rice water, homemade liquid food or commercially available preparations are all possible choices. Check with your nutritionist for a balanced meal plan and preparation method.
  • Keep a diary to keep track of patient weight, intake amount, undigested amount, any changes in stool or urine, any abdominal discomfort, or anything your doctor might need to know.
  • Clean the nostrils with a wet cotton swab of grease or other discharge daily. Practice good oral hygiene and brush with a soft toothbrush and toothpaste at least twice a day.
  • Change the nostril tape everyday and apply lotion or vaseline around the nostril if necessary. Slightly twist the NG tube to prevent it adhering to stomach wall.
  • NG tubes should be changed every 7 days. Silicon NG tubes may be changed once a month.
 
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