Caring for a child or an elderly person who finds it difficult to swallow may entail the use of a nasogastric tube, aka feeding tube or an NG tube. It’s not easy, especially for a family member, to see a child, infant, or senior receiving their nutritional needs through nasogastric tube feeding or NGT feeding.
The challenge becomes more difficult when inserting a nasogastric or NGT tube into an adult or child’s nose. What do you need to know about nasogastric tube feeding? How does a feeding tube or NGT tube work? What’s the right placement of the tube? And how do children and adults benefit from using a feeding tube or NG tube in nasogastric tube feeding?
Let’s shed light on nasogastric tube feeding and all it entails.
What You Need to Know About NGT Tube or Nasogastric Tube Feeding in Singapore
The NG tube or feeding tube used in nasogastric tube feeding is a type of catheter used in medicine that is inserted into the stomach through the nose. It is used to draw out or deliver substances to your stomach, such as food or medications, for a limited time.
You can learn proper tube placement and medication administration through nasogastric tube feeding. But if you’re not up for the task, you can get a home nurse for your child or older patient or book the latter in elderly care in Singapore.
Definition of Key Terms
To make it easier to understand the concept of nasogastric tube feeding, tube placement, feeding set tubing, nasogastric NG, nasogastric tubes, feeding pump, and more, let’s define what it’s all about.
Here are some of the terms you may encounter while learning about nasogastric tube feeding:
Nasogastric tube (NG tube)
NG tube or feeding tube is made of thin and flexible plastic and used for medical purposes for a limited time.
Nasogastric
The term translates to nose to the stomach. This means that the nasogastric tube or NG tube will be injected into the patient’s nasal cavity to access the throat and oesophagus until the NG tube reaches the stomach.
Different nasogastric tubes are used to draw out or deliver substances to a patient’s stomach.
Nasogastric tube feeding
The NG tube or feeding tube can be used to deliver medication and specific nourishment to your stomach. Nasogastric tube feeding is required when the patient cannot get adequate nutrition through oral feeding.
In this case, tube feeding provides enteral nutrition to help sustain the patient’s health despite their condition.
Nasogastric tube feeding is typically required by patients suffering from a condition that impairs their ability to chew or swallow. There are also cases in hospitals when patients undergo nasogastric tube feeding to take in more calories than their bodies require.
Here’s a list of the patients who may be required to undergo tube feeding using an NG tube:
- Endotracheal intubation
- IBD or inflammatory bowel disease
- Malnutrition
- Unconsciousness or altered mental state
- Cancer in the neck or head
- Dysphagia or having difficulty swallowing
- Gastric suction
Your doctor might use the nasogastric tube feeding technique to remove the contents of your stomach in an emergency or as a preventative measure. For example, your doctors will use nasogastric tube feeding if you take too many medicines or ingest poison. Nasogastric tube feeding will remove toxins from your system before they can harm you further.
Additionally, doctors can use an NG tube if you’re suffering from a condition that leaves your stomach distended and overfull. They will use the NG tube to remove stomach contents, decompress your stomach, and stop regurgitation.
Here’s a list of the patients who may be required to undergo gastric suction using an NG tube:
- Gastrointestinal surgery
- Bleeding in upper GI
- Vomiting and intractable nausea
- Pseudo-obstruction or small bowel obstruction
- Gastric outlet obstruction or gastroparesis
- Poisoning or toxic ingestion
For the other terms and concerns regarding NG tubes and tube feeding, you can check the government guidelines on NGT feeding.
Two Types of NG Tubes Used in Tube Feeding
There are two types of NG tubes primarily used in tube feeding:
Single-lumen tubing
This tubing used in tube feeding has a single narrow channel that delivers nutrition and medication to your stomach. It has a small bore or small diameter that makes the process easy on the patient. This is crucial since the tubing will be in its place for several weeks.
There are currently two models being used for single-lumen tubing. They are Dobhoff and Levin, which are similar in many ways, aside from the weight placed at the end of the tube of the Dobhoff model.
Double-lumen tubing
The double-lumen tubing is mainly used for suctioning. This tubing has two channels: narrow and wide. The narrow tube relieves vacuum pressure by acting as an air vent. The wide channel is used in suctioning.
Since there are two channels, your stomach is protected, so the tube won’t get into contact with your gastric lining. Many models are being used for the double-lumen tube, but the most prevalent one is the Salem Sump.
How Do Food or Medication Get In or Out of Your Stomach Through the Gastrostomy Tube
Each tube has one or more ports (depending on the type), allowing access to the stomach and stomach contents. The ports are attached to a small syringe or tube for nourishment and hydration when administering liquid drugs and fluids.
The doctor sets the patient’s feeding time. It will depend on the patient’s condition. For example, a child’s doctor will frequently administer a precise volume of liquid food through continuous feeding. This tube-feeding strategy will utilize a controlled pump to prevent causing abdominal pain in a child’s stomach. This technique benefits patients whose stomachs cannot handle a lot of food at once, like a child or an older adult.
Another option is to receive a bolus, a predetermined amount of liquid food administered all at once. This tube feeding technique is typically given multiple times per day to replace a meal.
The advantage of this is that you won’t need to depend on a machine for extended periods, making it simpler to carry out daily activities.
On the other hand, nasogastric tubes used in removing stomach contents are often exclusively utilized in hospital settings. It is also administered to patients with acute illnesses.
Depending on their care and maintenance, some NG tubes can be left in place for up to six weeks before changing. But the doctor may reassess if the child begins to find the tube uncomfortable or painful. They might change the tube or find other ways to feed the patient when the child’s neck or the child’s skin begins showing signs of stress and strain.
All About the Risks and Complications of Nasogastric Intubation
The advantages of set tubing or tube feeding outweigh the risks because NG tubes are only advised when medically necessary. A feeding pump, feeding bag, set tubing, and other elements comprising tube feeding are generally safe.
However, the doctors and caregivers of the patient need to be aware of the proper use of the feeding pump, how to connect sucking works, and how to check the placement and the correct position of the tube feeding. They also need to be informed about the possible side effects of the process.
For one, the misplacement or displacement of a nasogastric tube is one of the most dangerous problems that can happen. It can result in fluids delivered through the nasogastric tube ending up in the lungs instead of the stomach. If not helped and a doctor does not immediately treat the patient, the problem can lead to pneumonia.
When is it safe to administer a nasogastric tube for tube feeding? First, the correct technique must be used. Second, the insertion needs to be verified. And last, the acidity of the stomach contents must be assessed before each administration.
Another risk of using a nasogastric tube is that the oesophagus or stomach may occasionally get damaged or perforated due to the insertion. It can lead to nasal bleeding, pain, and sometimes blisters in or around the nose.
Moreover, blood clotting issues are more likely to affect those with bleeding disorders or who take blood thinners like Warfarin.
How can I reduce the possibility of complications from having nasogastric tube insertion?
It’s crucial to double-check the placement of the tube before each feed. Some liquids delivered through the tube could be inhaled into the lungs, resulting in aspiration pneumonia.
Nasogastric tubes include markings throughout their lengths to make it simple to determine if the tube is fully inserted. Displacement is more likely if you’ve frequently been coughing, throwing up, or retching.
Before each dosage, a small amount of the stomach contents should be sucked into a syringe, and the pH should be tested. While giving anything through the tube, it’s crucial to make sure the surroundings and equipment are clean. It’s also essential to frequently sanitize the nasogastric tube with water to keep it clear and clean.
It’s crucial to be aware of the warning signs to minimize any risks related to administering a nasogastric tube. You must also check the patient’s respiratory issues and how they respond to the nasogastric tube.
Aside from nutrition, you can also use nasogastric tube feeding to administer the liquid medication. In some cases, the drugs are turned into fine powder and dissolved in water.
A pharmacist or doctor can advise you on the optimal pharmaceutical forms or prescribed amount to pass through your nasogastric tube. However, be aware that some tablets should not be broken, and some capsules should not be opened.
The Checklist of What You Need to Have to Administer Nasogastric Tube Feeding
Here are the things you must take note of when using or administering nasogastric tube feeding:
- Verify that the micropore holding the tube is still in place and has not moved.
- Measure the tube’s exposed length. You must keep the exposed length from when the feeding tube was first introduced. For reference, some tubes have numeral markings.
Keeping Your Oral Hygiene and the Nasogastric Tube Clean
Some patients who use nasogastric tubes can also eat and drink regularly. In this case, they must ensure to follow good oral hygiene practices. They include the basics, such as brushing your teeth and drinking plenty of water.
Others might not be able to swallow anything; hence, they are placed in a nasogastric tube. It can cause their mouths to dry and hurt. It is essential to moisturize and follow good dental hygiene to keep the fragile tissues of the mouth healthy. These practices can help prevent mouth ulcers, fissures, and oral thrush.
Some people find the small “lollipop”-style sponges handy because they are developed exclusively for oral care. Moreover, they are not meant to shatter into pieces or be unintentionally ingested.
While nasogastric tubes are used for feeding, they can clog because they are fairly narrow. Before and after each feed, it’s crucial to flush them with clean water to ensure that none of the feed is trapped in the tube. This is the best way to prevent clogging inside the tube.
If certain drugs are not properly flushed, notably suspensions or dispersible powders, they may also result in obstructions. You can purchase specialized tablet crushers if you take pills that a pharmacist says can be crushed to ensure they are smashed to a fine powder before oral intake.
Final Thoughts
A nasogastric tube can be a long-term solution for ongoing medical needs or a short-term fix for an acute illness. Some people can independently set up and administer NGT for medications and nutrients.
But most family caregivers require knowing hands to ensure they do things right. If you need a pro to assist you with your NGT concerns, you can count on RC Caregivers to provide them. This top nursing agency Singapore offers fast and reliable medical assistance when you need them, where you need them.
