Nasogastric tube feeding

The patient maybe discharged with a feeding-tube called a nasogastric tube, or Ryles tube. The NG tube is inserted through the patient’s nose and into his/her stomach to provide them with food, fluids, and medication. This maybe because the patient has difficulty swallowing safely or adequately.

Here’s what you need to know about caring for the nasogastric tube:

Giving the Tube Feeding -

Equipment

Before giving your feeding, you will need:

50ml syringe
the liquid food prescribed by your doctor or dietician
clean steel glass
clean food container

Instructions

Wash your hands before starting the feeding.
Sit your loved one in a chair or up in bed (90 degrees upright) during the feeding and for 1/2 hour after feeding.
Do not feed in a lying down position as it may increase the risk of the food going into the patient’s lungs.
Before feeding begins, check to see that the stomach is empty by doing the following:-
- Insert the tip of an empty syringe into the end of the NG tube.
- Pull back the plunger to withdraw the contents of your stomach (yellowish-greenish)
- Don’t begin the feeding if more than 100 ml remains from the previous feeding.
Remove the plunger of the syringe.
Pinch the tube with your fingers to clamp it.
Fill the syringe with 50 ml of liquid food.
The formula should be warm, not hot.
Open the clamp and allow the formula to flow into the NG tube.
Repeat the step until the amount of feeds suggested has been given eg. 4 times if the volume to be given is 200 ml.
Then finish the feeding with 25-50 ml of plain warm water.

If you have choking or difficulty breathing during a feeding, stop the feeding and if it recurs again, seek medical help.

After each feeding, rinse the syringe. Every 24 hours, wash with soapy water. Rinse thoroughly.

Giving Medications Through The NG Tube

Use the liquid form of your medication if it is available. If not available, you must crush the pills.
Flush the feeding tube with 30 ml of water before giving your medication.
Crush the pills finely. Let the pieces dissolve in warm water (not hot water) so that no pieces will clog the tube.
Draw medication up into the syringe by pulling back on the plunger.
Attach the syringe to the end of the feeding tube. Then push the plunger to give the medication.
Flush the tube with 30 ml of water after giving the medication.
Some medications should be given with food; others on an empty stomach. Ask your doctor for directions.

Mouth and Tube Care

The patient must brush their teeth twice daily, and the mouth must be cleaned using chlorhexidine and H202 as advised by the doctors.
Clean the area where the NG tube goes into the nose daily. Use a gauze pice moistened with warm water.
Change the nose tape every other day or when it is loose.
Make sure the nose tape is secure at all times. If the feeding tube falls out, do not re-insert it by yourself but seek medical help as soon as possible.
To prevent a clogged feeding tube, flush the tube with water each time after giving a feeding or medication.
If the tube becomes clogged, you can try to:
– Place the syringe into the NG tube, and pull back on the plunger.
– Flush the tube with warm drinking water.
If you cannot unclog the tube, seek medical help immediately. It is important not to miss any prescribed liquid food, water or medication.

What Not To Put Into The Tube

Semi -solid or solid food (eg rice, khichdi)
Hot liquid (eg. soups, hot tea/milk).

When to Seek Medical Help

Seek medical help immediately if the patient has any of the following:-

Repeated choking or difficulty breathing during a feeding.
Blocked tube.
A tube that is dislodged from the nose.
If any of the following last for more than a day: diarrhea, constipation, nausea, fever.