1.1. Giving nasogastric tube feedings
∑ Equipment: Liquid food at room temperature and water in pour container, feeding tube, adhesive 1-cm or ½-inch tape, water, syringe, stethoscope.
∑ Positioning for procedure:
o On parentís lap on infantís right side,
o or reclining him in an infant seat.
∑ Measuring the tube for the exact distance (See picture):
o Hold the tip of the tube on the childís stomach (midway between the belly button and the highest point of the lower rib cage).
o Extend the tube up to the childís ear lobe then out to his nose.
o Mark the spot at the nose with the piece of tape.
∑ Inserting the tube:
o Dip the tip of the tube in clear water to moisten
o Insert the tip of the tube into one nostril guiding it toward the back of the childís throat
o Ask the child to swallow or give him some water to help the tube pass
o Quickly insert the tube to the tape mark on the tube.
o If the child begins coughing or has any other problems, remove the tube at once.
o Tape the tube to the childís upper lip and cheek.
∑ Check the placement of the tube:
o Place 5 cm³ of air in the syringe, connect the syringe to the tube
o Place the stethoscope over the childís stomach area.
o Inject the air into the tube while listening for the sound of gurgling through the stethoscope.
o With the syringe connected to the tube, gently pull back the plunger. If† contents appear in the tube, it is the correct place.
o If not, place the child on the left side or advance the tube a short distance. Pull back on plunder again to check for stomach contents.
o Return the stomach contents.
o Disconnect the syringe from the tube and remove the plunger from the syringe.
o Reconnect the syringe to the tube.
o Fill the syringe with the right amount of food.
o If necessary push gently with the plunger to start the flow of food. Then remove the plunger and allow the food to flow by gravity.
o The bottom of the syringe should never be held higher than the childís chin.
o Continue adding food until the right amount has been fed. Do not allow the syringe to become empty.
o When the food is at the bottom of the syringe, add 1 teaspoon (5 ml) of water to rinse the tube.
o Place the clamp on the tube if it will be left in place between feedings.
o Hold, cuddle and burp the child.
o Write down the time and amount of the childís feeding.
∑ To remove the tube:
o Loosen the tape that is holding the tube.
o Fold the tube and pinch it tightly together.
o Pull the tube out quickly.
o Hold, cuddle, and burp the child.
∑ Care of the nasogastric tube and syringe
o Wash with soap and water, and rinse the inside well with clear water.
o Dry and store in a clean, dry container (e.g., plastic bag, margarine container).
o If the tube remains in place between feedings, always check to make sure the tube is in the right place before adding formula.