1. Supplies
- Appropriate size NG tube
- K-Y jelly or water to lubricate NG tip
- Syringe - 3, 5, or 10 cc
- Tape or tegaderm
- Stethoscope
- Extension tube
- Syringe (50 cc) or feeding bag
Placement of NG
1. Gather supplies.
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2. Wash your hands.
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3. Cut a piece of tape.
4. If appropriate, explain the procedure to the child.
5. Place child on right side or semi-sitting.
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6. Measure tube for the exact distance you will have to insert it. Hold
the tip of the tube at the end of the nose and measure to the ear. Then
measure to the stomach (midway between the belly button and the highest
point of the lower rib cage). Mark tube with marker or tape.
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7. Dip the end of the tube in water or K-Y jelly to moisten.
8. Insert the tip of the tube into one nostril guiding it toward the back
of the child's throat.
9. Have the child swallow the tube to help it pass (infants may suck on
pacifier).
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10. Quickly insert the tube to the mark measured. If the child begins
coughing or has color changes, REMOVE the tube at once. DO NOT force tube
if it appears stuck. Check mouth for curling in the back of the throat,
if present, remove tube and try again. May need to freeze or obtain new
NG if kinking is a problem.
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11. Check placement after placing tube and before EACH feeding. Attach
5 cc syringe and pull back on syringe. If stomach ontents (clear to rust-colored
fluid) appear, NG tube is in correct place. Return the stomach contents.
Instill 1-2 cc of tap water and observe child for cough or color change.
If unable to pull back stomach contents, advance tube two inches and try
again. If still unsure of placement, remove tube and try again.
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12.Tape tube to child's cheek and mark at the nares with colored marker
and check prior to each feeding.
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NG Tube Feeding
1. Aspirate for stomach contents. If unable to aspirate stomach contents,
turn patient on left side and/or advance the tube a short distance.
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2. Return stomach contents.
3. Remove syringe and clamp NG tube.
4. Check the placement marking at the nares.
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5. Assemble feeding bag and tubing.
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6. Measure and pour appropriate amount of formula into the bag.
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7. Flush tubing with formula.
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8. Attach tubing to end of NG tube. Secure with tape.
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9. Set pump to infuse ordered amount.
10. A m feeding bag.
11. To prevent clogging of the NG feeding tube, flush the tube with water
before capping.
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Tips and Concerns
Prepared formula must be discarded 24 hours after opening even if refrigerated.
Tube may become displaced with coughing, retching, vomiting or pulling on the
tube.
Elevating the head of the bed, or having the child lie on the right side may
help speed digestion.
If your child experiences coughing or shortness of breath, discontinue the
feeding immediately.
Only put four hours worth of formula in bag at one time.
If your child takes the medication phenytoin (dilantin) suspension, this medication
must be given at least two hours after a tube feeding is complete and two hours
before the next feeding as the feeding interferes with absorption.
The feeding bag and tubing should be changed every 24 hours.
The NG feeding tube itself should be changed every seven days.
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