How to feed the patient through a nasogastric PE tubing?

29 July 21

How to feed the patient through a nasogastric tube?

Gastric bypass is a supportive procedure for people where PE tubing is used when patient cannot chew or swallow on their own (patients with cerebrovascular accident, head and neck trauma, mechanical obstruction of the upper gastrointestinal tract such as esophageal cancer, cancer of the gastrointestinal tract).

Learning about how to feed a patient through a nasogastric tube will help the patient’s loved one become more confident and competent in caring for the patient.

The role of nasogastric tube feeding

In the 1980s, critically ill patients were often fed intravenously. However, one of the biggest disadvantages when feeding intravenously is that the intestinal tract is empty, creating conditions for bacterial gonorrhea to occur, causing infection and blood poisoning.

Therefore, since the late 90s of the last century, experts have encouraged early enteral nutrition for critically ill patients. Therefore, catheter feeding is a method of feeding critically through PE tubing to ill patients in most hospitals.

Feeding through a nasogastric tube

Patients with this method are usually fed directly into the stomach to improve their condition. Patients cannot eat by mouth due to tumors in the mouth, throat, neck, chest and esophagus, causing compression, making patients unable to swallow, or prolonged swallowing, causing pneumonia due to stroke and brain disorders.

Preparation before catheter feeding

• Liquid food is prepared: ensure milk, liquid porridge…
• Photo transfusion and fluid tubes
• Food bags or bowls.
• 50ml feeding syringe.
• Before feeding, it is necessary to inform the patient if the patient is awake, if the patient is not awake, notify the patient’s family.

How to feed the patient through the PE tubing

Check that the PE tubing is still in the correct position in the stomach (inflates and listens to the epigastrium or use a suction pump to see gastric juice). Connect the liquid feeding bag to the catheter, adjusting the drop to match the calories. Each feeding time is about 3 – 6 hours. After each feeding, pump cooled boiled water or sterile water to flush the catheter.

 

Pay attention when pumping water and food into the stomach to avoid bringing air into the stomach. Start feeding 8 – 24 hours after the procedure. The amount of feeding fluid started with 40ml/4h, and then gradually increased 25ml/every 12 hours to reach 250ml/4h. Feeding tubes can be used from 6-12 months, if there is an indication to continue feeding, replace with new feeding tubes.

What is the dosage of calorie required for?

Large bowel resection on the first day 250 calories, mainly glucose, gradually increases each day 250 calories. Feed the patient milk through the PE tubing. The required calorie dosage depends on each disease: normal digestion: 30 – 50 calories/kg.

• First day: 1000 – 1400 calories.
• Day two: 2000 – 2500 calories.
• Bacterial infections: 50 calories/kg

Dealing with complications when feeding through a nasogastric tube

• Diarrhea: Reduce the diet, reduce the rate of infusion, check for environmental pollution, check the operations performed.
• Vomiting: Sometimes occurs due to eating too quickly, too much at one time due to incorrect indications, for the patient to lie on the side of the head or in a safe position.
• Weight loss, weight gain:Adjust food intake.
• Aspiration pneumonia: Due to too much feeding at a time or because PE tubingTreat by reducing the amount of feeding fluid per pump, keeping the head elevated when pumping through the tube until 1 hour after feeding.

What is a nasogastric tube?

A nasogastric tube is a method of using a tube into the stomach to nourish food directly from the patient’s body, aspirate gastric juice and monitor the condition of the stomach. The technique of nasogastric tube placement will be applied when the patient loses the ability to eat normally, there are 2 common ways:

• Sugar from mouth to stomach
• The way from the nose to the stomach

Indications for PE tubing placement

The technique of PE tubing placement is indicated for the following cases:

• People with cancer
• Tongue
• Esophageal cancer
• The comatose

Difficulty swallowing due to facial paralysis

• People who refuse to eat or eat too little are not enough to maintain health
• People with acute gastritis and chronic gastritis or stomach cancer
• Suspicion when diagnosing pneumonia , pulmonary tuberculosis in children
• In case the patient has abdominal distention after surgery
• Abnormalities in the gastrointestinal tract
• Respiratory failure, asphyxiation when the patient has difficulty in eating
• Patient gastric lavage due to food poisoning then PE tubing is useful
• The technique of nasogastric tube placement will be applied when the patient loses the ability to eat normally
  

Gastric catheterization procedure

Place the patient in the semi-reclining position (the patient is awake) or the head is low, the face title to the left (the patient is comatose).

Lubricate the tip of the catheter (about 5cm, do not allow oil to accumulate in the tube to make the patient choke). Ask the patient to open their mouth or, using a mouth opener (the patient is not conscious), insert the PE tubing through the mouth. If it is difficult, you can thread it through the nose along the way of the nostrils.

How can we use PE tubing?

Gently insert the tube into the mouth, close to the cheek, avoiding the nasopharynx and uvula, encouraging the patient to swallow despite the discomfort, while the nurse slowly pushes the tube and stops when the marker reaches the dental arch. If the patient has choking, severe cough, pale face, purple lips, pull out and bring back.

Check if the PE tubing has entered the stomach correctly by 3 ways: pump about 30 ml of air and listen to the epigastrium and see the sound of gas flowing through the water or use a syringe to suck gastric juice or immerse the outer end of the catheter in a cup of clean water no bubbles seen. Secure the nasogastric tube with adhesive tape. Insert the drainage bag into the tip of the nasogastric tube.

How to take care of a patient with a PE tubing

When taking care of a patient with a tube, the patient’s head should place at a height of about 30-45 degrees. If it is too low or too high, it is not good for the process of feeding the patient without PE tubing. At the same time, prepare some necessary tools such as towels and cleaning tools to help the food transmission process be cleaner and more thoughtful.