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NASOGASTRIC TUBE FEEDING TTSH

Nasogastric tube (NGT) feeding is giving of liquid food through a tube that is inserted into the stomach through the nose. It is recommended for a person who is unable to chew or swallow.

A. PREPARATION

1. Gather the required items:

A. Recommended feed

B. Measuring jug for feed

C. Cup to receive stomach contents

D. Water for flushing

E. 60m1 syringe

F. pH indicator paper in a container

2. Wash and dry hands.

3. Prepare the formula feed as recommended:

·   Pour required amount of feed into a measuring jug. Keep the balance in the fridge.

B. FEEDING STEPS

1. Raise the patient to a sitting position or at least 45 degrees.

2. Check that the tube is in the stomach by using the following method:

·        Kink the feeding tube and connect the tip of a syringe into the feeding tube. Gently draw back the plunger to withdraw the stomach contents. Dip a pH indicator paper into the stomach contents if any. It should range from 1 to 6.

If there is no stomach contents, do the following:

·         Check the mouth, ensure no coiling of tube

·         Dip the tube into a cup of water: there should not be a continuous bubbling.

Dip the tube into a cup of water

DO NOT FEED if bubbles are present. Seek professional help.

3. Check for undigested feeds from the previous feeding by withdrawing all the stomach contents with a 60 ml syringe.

·        If the amount is less than 120m1s. return the stomach contents and start to feed the balance amount.

Note; Total volume should not more than 300 mls for each feed

If the amount is more then 120m1 return the stomach contents, omit feed and check again 2 hours later. 2 hours later:

·         Feed if the amount is reduced

·         Do not feed if the amount is still 120m1s, or more. Contact your health care professional.

4. Place the tip of the syringe into the feeding tube and hold it at the level of the patient's head.

Hold it at the level of the patient's head

5. Pour the prescribed feed into the syringe and allow it to flow slowly.

6. Observe the patient's tolerance while feeding.

C. AFTER FEEDING

1. Flush the tube with 20m1 of water (unless recommended otherwise by the healthcare professional).

2. Kink the tube and disconnect the syringe. Replace the feeding tube stopper.

3. Do not turn or lay patient flat for at least half an hour after the feeding.

4. Wash the feeding set with water. Remove excessive water and store the feeding apparatus in a clean container.

5. Wash and dry your hands.

DO

·        Keep the mouth and nose clean.

·        Perform oral care 3 times a day.

·        Ensure that the apparatus is clean and dry before each use.

·        Wash and dry your hands before and after preparing the feeds.

·        Check for expiry date of the enteral feeds formula before use.

·        Clean the top of the can with a damp paper towel before opening.

·        Store the feeds in cool dry place.

·        Refrigerate balance feed immediately.

DO NOT:

·        Feed if patient coughs, chokes or has difficulty breathing.

·        Use force to unblock the tube

·        Mix medication with the formula feed.

·        Use microwave to warm the feed.

Withhold feeding and seek professional advice if you observe:

§         Breathlessness

§         Restlessness

§         Nausea

§         Vomiting

§         Diarrhoea

§         Bloated stomach

§         Aspirate more than 120m1s on 2 consecutive times

HELPLINE

If you have any question or would like more information, please contact:

Ward:

Telephone:

For tube feeding service, please contact:

Home Nursing Foundation

Private Nurse Agency

General Practitioner

Tan Tack Seng

FI O S P I 'rA L

NASOGASTRIC TUBE FEEDING

What you need to know

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