Caring for a Nasogastric (NG) Feeding Tube

Equipment

  • Nasogastric feeding tube illustration Oral syringe
  • Water
  • Tegaderm
  • Duoderm

Taping the Tube

It is important to secure the tube with tape for 2 reasons:

  • To prevent it from falling out
  • To prevent the tube from moving out of place

There are numbers along the length of the tube.

  • We will tell you what number should be showing at the edge of your child's nostril.
  • Mark the tube at this number with a permanent marker or a piece of tape.
  • Use this mark to determine if the tube has moved.

If the tape that holds the tube becomes loose, you must secure the tape to prevent the tube from falling out or moving. Follow the steps below:

  • Taping a feeding tube illustration Measure and cut Duoderm.
  • Measure and cut the Tegaderm to the correct size.
  • If using a skin barrier, apply it to the skin where you will be putting the Duoderm.
  • Peel backing off of Duoderm to expose adhesive.
  • Place Duoderm on your child's cheek.
  • Place the NG tube on top of the Duoderm.
  • Peel the backing off of the Tegaderm to expose adhesive.
  • Place the Tegaderm over the tube onto the Duoderm.

When re-taping the tube, hold the tube firmly in place to prevent movement. After re-taping, check the mark you have made on the tube to determine if the tube has moved.

Checking Placement of the Tube

Attach an oral syringe with 5ml of air to the side port. Flush the tube with the air to clear the tube of any fluid.

  • Slowly pull back on the plunger of the syringe to get stomach contents. Completely cover the test area on the pH strip with the fluid. Check the pH. Gastric (stomach) pH should be 1-5.
  • If your homecare company does not provide pH strips, you will need to purchase them. They may not be the brand that you were taught how to use. It is important to know that the pH color scale may be different for each manufacturer. Read the product information carefully so that you get an accurate pH level for your child.
  • If the pH is greater than 5 and your child is not having any trouble breathing or changes in behavior, wait 15-30 minutes and recheck the pH.
    • After rechecking, if the pH is still greater than 5, call your doctor or nurse practitioner.
  • If you are unable to pull back any fluid:
    • Push 3-5ml of air into the tube and try again to pull back fluid. You may repeat this 2 to 3 times.
  • If you are still unable to pull back any fluid:
    • Lay your child down on his left side. Wait a few minutes and try again to pull back fluid.
  • If you are not sure the tube is in the stomach, call your doctor or nurse practitioner.

Once you have confirmed that the tube is in the stomach, flush the tube with the amount of water or air as you have been taught.

To Prevent the Tube From Clogging

  • Always flush the tube with the amount of air or water as you have been taught before and after each feeding and before and after medications.
  • For continuous feeds, flush every 12 hours.
  • If your tube does become clogged, attach a 5ml oral syringe with warm water to the end of your feeding tube. Try to flush the tube. If you are unable to flush, pull back on the plunger of the syringe. Repeat this push and pull action up to 5 times. If you still cannot flush the tube, try warm water in a 3ml or 1ml oral syringe and repeat the above steps 

Future Reminders

  • Check the pH before giving your child any medications and before giving anything to eat or drink.
  • Always check that the mark on your child's feeding tube has not changed. If the mark has moved, reposition the tube and check your child's pH.
  • Always check the placement (pH) of your child's feeding tube if they do not seem the same and you think something is wrong.

Remove the Tube and Call your Doctor or Nurse Practitioner if:

  • The tube comes out or is clogged.
  • Your child starts choking.
  • Your child has trouble breathing or his face turns bluish-gray in color.

07:B:11b
Written 5/16

©The Children’s Hospital of Philadelphia 2016. Not to be copied or distributed without permission. All rights reserved.

Patient family education materials provide educational information to help individuals and families. You should not rely on this information as professional medical advice or to replace any relationship with your physician or healthcare provider.


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