Nasogastric (NG) Tube
Before the Procedure
It’s always good to have a loved one around during the tube placement for moral support. If you are a caregiver of the teen or young adult getting the tube, and you know your loved one can sometimes be a little uncooperative, you might be called on to help hold them during the placement.
During the Procedure
Throughout the procedure you or your loved one may be asked to sip water from a straw to help pass the tube down to the stomach. A nurse will determine how far to place the tube by measuring the length from nose to the tip of the earlobe to the midpoint between the breastbone and belly button.
Before placement, the tube will be dipped in water or lubricating jelly to make it slick. Lubricating jelly can cause a burning sensation in the nasal passages, so using water instead, may be preferred. The nurse will then ask you or your loved one to tilt your head slightly forward, as this will help the tube pass more easily through the nose and throat into the esophagus and stomach. Gagging is very likely to occur. This can be uncomfortable to watch, but being there for your teen or loved one may provide them comfort and support.
Afterward, a nurse will teach you or your loved one how to confirm that the tube is placed right. If a stylet was used to guide the tube into the stomach, it will be removed and the tube will be taped to their cheek.
After the Procedure
The staff will teach you how to fill the feeding bags and run the pump. If a pump isn’t used, you’ll be taught how to give feedings without one, using a syringe or gravity feed with a bag.
Frequent toothbrushing and good oral hygiene is very important. You’ll also want to ask if it’s OK to sip water and eat food if oral intake is possible.
Before you leave, make sure you have all the take-home supplies you need or at least know the plan to get these supplies. This includes good quality tape to secure the tube, syringes, and an extra NG tube. You can reuse the same tube more than once, as long as you wash it with soapy water, rinse it, and let it air dry.
Your First Day at Home
Next, you or your loved one will be placing the tube by themselves for the first time. It’s normal to feel a little nervous; just remember that the nurses taught you everything you need to know. Remind yourself or your loved one of this so they can feel calm, and make sure their stomach is empty for the first placement.
Lubricate the inside of the tube with water, and have it and the stylet ready and in place. Know how many centimeters are needed to be inserted based on what the nurses told you. If you are replacing the tube, use the other nostril and alternate back with each replacement. After your the tube has been inserted, confirm the placement before using it. If it feels a little wrong or funny, don’t worry. Just remove the tube and reinsert it.
Have the feeding bag with formula set up on the pump. If you don’t use a pump, have the feeding set or syringe ready for use and on hand so you can begin your feeding after the tube is in place.
The tube can stay in place for weeks. But if you’re using a continuous feed, you may change it weekly if it becomes clogged.
Remember: the first day at home after any big change is going to require some adjustment. But before long, you’ll become more used to what to do and how to do it and you’ll develop a new routine that’s second nature to you.