Miyerkules, Mayo 2, 2012 | 4:02 AM | 15 Cotton Candy
Enteral Feedings
Enteral feeding refers to the delivery of a nutritionally complete feed, containing protein, carbohydrate, fat, water, minerals and vitamins, directly into the stomach, duodenum or jejunum.
A nasogastric tube is used for feeding and administering drugs and other oral agents such as activated charcoal. For drugs and for minimal quantities of liquid, a syringe is used for injection into the tube. For continuous feeding, a gravity based system is employed, with the solution placed higher than the patient's stomach. If accrued supervision is required for the feeding, the tube is often connected to an electronic pump which can control and measure the patient's intake and signal any interruption in the feeding.
A nasogastric tube is used for feeding and administering drugs and other oral agents such as activated charcoal. For drugs and for minimal quantities of liquid, a syringe is used for injection into the tube. For continuous feeding, a gravity based system is employed, with the solution placed higher than the patient's stomach. If accrued supervision is required for the feeding, the tube is often connected to an electronic pump which can control and measure the patient's intake and signal any interruption in the feeding.
A nasogastric feeding tube or NG-tube is passed through the nares (nostril), down the esophagus and into the stomach. This type of feeding tube is generally used for short term feeding, usually only 2 weeks maximum.
NASOGASTRIC TUBE INSERTION
- Gather equipment
- Don non-sterile gloves
- Explain the procedure to the patient and show equipment
- If possible, sit patient upright for optimal neck/stomach alignment
- Examine nostrils for deformity/obstructions to determine best side for insertion
- Measure tubing from bridge of nose to earlobe, then to the point halfway between the end of the sternum and the navel
- Mark measured length with a marker or note the distance
- Lubricate 2-4 inches of tube with lubricant (preferably 2% Xylocaine). This procedure is very uncomfortable for many patients, so a squirt of Xylocaine jelly in the nostril, and a spray of Xylocaine to the back of the throat will help alleviate the discomfort.
- Pass tube via either nare posteriorly, past the pharynx into the esophagus and
then the stomach.
Instruct the patient to swallow (you may offer ice chips/water) and advance the tube as the patient swallows. Swallowing of small sips of water may enhance passage of tube into esophagus.
If resistance is met, rotate tube slowly with downward advancement toward closes ear. Do not force. - Withdraw tube immediately if changes occur in patient's respiratory status, if
tube coils in mouth, if the patient begins to cough or turns pretty colours - Advance tube until mark is reached
- Check for placement by attaching syringe to free end of the tube, aspirate sample of gastric contents. Do not inject an air bolus, as the best practice is to test the pH of the aspirated contents to ensure that the contents are acidic. The pH should be below 6. Obtain an x-ray to verify placement before instilling any feedings/medications or if you have concerns about the placement of the tube.
- Secure tube with tape or commercially prepared tube holder
- If for suction, remove syringe from free end of tube; connect to suction; set machine on type of suction and pressure as prescribed.
- Document the reason for the tube insertion, type & size of tube, the nature and amount of aspirate, the type of suction and pressure setting if for suction, the nature and amount of drainage, and the effectiveness of the intervention.
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