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How do I prepare for feeding ?

Always wash your hands with soap and water and dry them before caring for the tube.

Do not put water, feed or medication through the tube until you have checked that the tube is in the correct position.Check tube position ( By checking marking) before feeding .

When should I check the position of the nasogastric tube?

• Before giving a feed
• Before giving medicine through the tube
• After you have vomited, retched or had a severe coughing bout
• If the tube looks longer
• If the tapes holding it in place have come loose
• If the tube is accidentally pulled or tugged
• At least once a day.

What to do if feed cannot be pushed through the tube

Try flushing an empty syringe the through the tube. If it doesn’t work then try pushing clear water through it. If still feed cannot go through then visit the hospital.

General care

To prevent unnecessary replacement of your nasogastric tube, it is important to keep it in good condition. Regular care and flushing of the tube will help to prevent the tube becoming blocked.

The external part of the tube can be cleaned with soap and water. Some discoloration of the tube is normal and does not affect its ability to deliver feed. Wash the rest of your face in the usual way. Check your nose for redness and any dry, sore or cracked areas. Change the tape securing the NG tube to the nose if it becomes dirty or starts to peel off.

Wash the rest of your face in your usual way.

If you are not using your NG tube, flush the tube with water at least once daily.

Can I administer medications down my nasogastric tube? Yes

• Liquids
  • Most liquid medicine may be given through the tube.
• Pills:
  • Some pills cannot be given after crushing – check with your doctor before crushing it.
  • First,crush the pill between two spoons (or use a pill crusher) to make a fine powder.
  • Mix the powder in water and make sure it dissolves completely and flush it through the tube
• Capsules:
  • Check with your doctor or pharmacist if it is okay to open the capsule.
  • Open the capsule and mix the contents with water
  • Draw up all of the mixture into a syringe and flush through the tube

The tube must be flushed with at least 30ml of cooled boiled water before and after giving any medication. This is to prevent the tube from getting blocked.

What do I do if my tube becomes blocked?

If you are confident that the tube is still in the correct position, for example the tube becomes blocked immediately after finishing your feed, try to flush the tube with warm water using a 60ml syringe.

If you can visibly see where the tube is blocked, massage the tube with your fingers and thumbs or put a warm compression on it to help break up the blockage.

If the tube remains blocked, gently draw back on the syringe and attempt to flush as before. It can take more than 30 minutes to unblock the tube, so be patient.

If unsuccessful, contact the doctor/hospital.

Do not attempt to unblock or administer anything down the tube, if you are unsure if the tube is in the correct position.

What do I do if my tube has come out?

If your tube has partially come out, slowly pull the remainder of the nasogastric tube out so the whole tube is fully out.

Contact your doctor immediately.

If it is after office hours or on a weekend, please go to your local Accident and Emergency Unit.

How do I look after my feeding equipment?

Feed Giving sets

If you are giving more than one feed a day, it is important that the giving set is stored correctly between feeds to keep it as clean as possible. When you have finished a feed, place the empty bottle with the giving set still attached in a plastic bag in the fridge. At the time of your next feed, disconnect the giving set from the empty bottle and immediately attach it to the new feed bottle. Throw away the old, empty feed bottle. This applies to both gravity feeds and feeds taken via a pump.

Repeat this process at the end of each feed and remember to throw away the giving set at the end of the day.

Syringes

• Reusable syringes are used for flushing water and medication down the tube.
• Some people will also use syringes to give feed down the tube (bolus feeding).
• Each reusable syringe can be used 30 times and for most people the syringe will last one week (four uses per day).
• Between each use the following procedure should be followed to clean the syringe:
  • Clean immediately after each administration using fresh, warm soapy water (domestic washing-up liquid) or immersion in boiling water of steam steriliser ( if allowed by manufacturer)
  • The plunger should be removed to allow for thorough cleaning.
• Allow to air dry (parts still separate)
• Once dry store in a clean, dry container
• Only reassemble syringe prior to use.

When to contact the doctor/hospital:

• Feed coming in the mouth/nose.
• Feed doesn’t go through the tube
• Tube falls out

How to take care of oral and nasal cavity when feeding through the tube:

• If you are using your tube for feeding, then you need to take care of your mouth, by cleaning your teeth/dentures and using a mouth rinse and lip balm.
• Nose can become dry due to tube and nasoclear nose drops once/twice daily can be used to be prevent crusting the nose and keeping the nose moist which prevents discomfort on slight movement of tube.