Introduction

The patient maybe discharged with a feeding-tube called a nasogastric tube, or NG 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 NG tube:

Essential Information

Giving the Tube Feeding

Equipment

Before giving your feeding, you will need:

• 50cc syringe
• the liquid/formula food prescribed by your doctor
• measuring cup
• clean food container

Instructions for Use

1. Wash your hands before starting the feeding.
2. Sit your loved one in a chair or up in bed (90 degrees upright) during the feeding and for 1/2 hour after feeding.
3. Do not feed in a lying down position or an inadequately upright position as it may increase the risk of the food going into the patient’s lungs.
4. 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.
5. Remove the plunger of the syringe.
6. Clamp the tube, either with a special clamp or by making a kink.
7. Fill the syringe with 50 cc of the feeding formula.
8. The formula should be warm, not hot.
9. Open the clamp and allow the formula to flow into the NG tube.
10. Repeat the step until the amount of feeds suggested has been given eg. 4 times if the volume to be given is 200 cc
11. Then finish the feeding with 25-50 cc 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 cc 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 cc of water after giving the medication.
• Some medications should be given with food; others on an empty stomach. Ask your pharmacist or doctor for directions.

Mouth and Tube Care

• Clean the patient’s mouth at least daily – use a moist towel to clean the tongue and toothbrush and floss the teeth.
• Clean the area where the NG tube goes into the nose daily. Use a cotton bud 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

• Food other than prescribed formula/milk (eg rice, porridge)
• Hot liquid (eg. soups, hot formula/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.