NG Feeding Tube | Cincinnati Children's

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How to properly care for an NG Feeding Tube at home

Mallory Heitfeld: "Hi, my name's Mallory. I'm 16 tears old, and I've had Crohn's disease for 8 years. From time to time, I need a feeding tube to get my nutrition in. I hope this video teaches you step-by-step instructions on how to put your NG tube in and troubleshoot at home."

Video Overview: In this short video, we will provide you with an overview of what supplies are needed to properly care for a NG tube at home. How to insert it, what safety precautions to take and when to call for help.

Always perform care in a clean environment. And remember, always wash your hands or sanitize your hands prior to inserting the tube.

The supplies needed for NG insertion will be given to you before discharge or delivered by your home care company to your home.

First, collect the following supplies:
- a cup of water
- a feeding tube
- secure items DuoDerm and Hypafix tape
- a 5 ml syringe
- and a pen or marker

Now that you have collected the necessary supplies, you are ready to insert the NG tube. If there is a stylette, pull back to make sure the stylette moves freely so it will be easily removed, and then push it back into place.

Cut a piece of DuoDerm to place on your child's cheek. Also cut a piece of Hypafixn to secure the tube once it is placed.

Next, measure from the tip of the nose to the top of the earlobe down to an area halfway between the belly button and the breast bone. Measure the tube from the tip of the nose to the tip of the earlobe down to an area halfway between the belly button and the breast bone and mark the tube at this spot. Marking the tube assists with initial placement and ongoing verification checks. Please make note: Do not measure around the ear. And measure on the side of the face the tube will be inserted on.

Next, lubricate the tip of the tube by dipping the tip in water to prevent the tube from clogging. Do not dip the tube into gels or Vaseline.

Finally, insert the tube through the nostril until you have reached the mark on the tube that you made with the pen or marker. It may help to offer your child drinks of water or sucking opportunities.

Attach the 5 ml syringe to the end of the feeding tube, and pull back on the syringe to obtain gastric contents. A small amount of gastric contents is needed to confirm placement and is usually cloudy, green, tan or off-white color. Throw away the gastric contents. Do not refeed.

The tube placement must be confirmed before starting any feeding. If you are unable to obtain gastric content to confirm proper placement:
- First, clamp the tube
- Place the child on their left side
- Wait 10 minutes and
- Reattempt to aspirate contents.

If still unable to obtain gastric contents:
- Remove tube
- Remeasure
- Reinsert the tube

If still unsuccessful, please notify the healthcare provider.

Secure the tube by placing the tube over the DuoDerm, then applying the Hypafix tape or however best meets the patient's needs.

Withdrawl the tube immediately if the child's color becomes blue or develops breathing problems. This is a sign that the tube may be in the child's lungs instead of their stomach.

If you use a tube with a stylette, remove at this time. Hold the feeding tube at the patient's nose and gently remove the stylette guide wire from the tube by pulling with the other hand.

However, remember, never reinsert the stylette guide wire into the NG tube.

If your child starts to gag or choke while doing the feeding:
- Lower the syringe of formula to slow the flow and pour what's left in the syringe into the bottle. Turn your child to their side and help clear the vomit if any present.
- Once your child settles, recheck tube placement.
- Resume feeding, but give it at a slower rate.

If your child becomes uncomfortable or his/her stomach becomes distended or puffs up:
- Stop the feeding and wait about 30-45 minutes. Restart feeding if resolved. Call your nurse or doctor if the discomfort continues.

Mallory: "I hope this video provided you with valuable instructions on how to place and care for your NG tube at home. The doctors and nurses at Cincinnati Children's are always available. If you have questions, day or night, don't hesitate to call.

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