As the most common route for people who need long-term enteral feeding, it is important to know how to take care of an NG tube, especially for caregivers or loved ones of those who depend on this equipment for their nutritional needs. Here is a guide that lets you know everything you need to know about nasogastric tubes.
What is an Nasogastric Tube (NGT)?
A Nasogastric (NG) tube is a thin soft tube that passes through the nose and into the stomach. It is used in enteral feeding a method where food intake is through the gastrointestinal tract.
What is a nasogastric tube used for?
The NG tube can transport food and medicine in liquid form into your stomach. By adding a suction, it can also be used to do the following:
– remove toxic and harmful substances
-get a sample of stomach contents
-relieve pressure on an intestinal obstruction or blockage
How do nasogastric tubes work?
Syringes, tubes or suctions can be attached to the port of the NG tube which gives access to the stomach. NG tubes are most used for feeding which can be done in small amounts or one go.
A programmable feeding pump allows measured amounts to be transferred into the stomach and reduces the chances of the body rejecting the treatment. The feed can also come in the form of a ‘bolus’ which is a liquid meal that can be administered in one go and given a few times a day This allows patients the freedom to move around without being attached to a machine.
Who needs a nasogastric tube?
A nasogastric tube is used for individuals who cannot eat or swallow and as such needs help to get the nutrients and medicine into their stomach. This may apply to stroke patients as well as to the elderly. It can also be used in the treatment of premature infants.
For those with nutrient deficiencies who cannot meet their nutrient needs through oral consumption alone, a dietician can recommend a formulation of NG feed that can supplement their oral intake and provide them with the mix of vitamins, minerals and nutrients they need.
NGT can also be used to treat drug overdose or accidental poisoning and can be used to deliver treatments that neutralize or reduce the chances of severe reactions.
Furthermore, acute illnesses may also cause unwanted build up in the stomach and the port of the NG tube can be attached to a suction which can then remove content from the stomach.
What is nasogastric intubation?
Nasogastric intubation is the procedure where a trained care provider, whether healthcare professional or trained caregiver, inserts an NG tube into the nose. NG tubes are made of soft and rubbery plastic tubes that are lubricated before insertion and a guided wire is used to stiffen the tubes allowing for easier insertion.
When Nasogastric Intubation is done in a hospital setting, they can use an x-ray to check if the insertion is correct based on the guided wire. Another way is to test the pH of the gastric contents of a sample taken from the NG tube. The acidity indicates if the tube is indeed in the stomach.
Types of Nasogastric Tubes
The types of NG tubes used depends on their usage. Some have a wider bore than those for NG tube feeding (like that of Ryles tubes) and are used for draining stomach contents. Others have two channels in a single tube and can be used for more complex aspiration of stomach contents.
It’s important to know which NG tubes to use as some are specific for long-term use while others can only be used short term.
What are the risks of nasogastric intubation?
Risks are mostly due to misplacement of the NG tube which results in the delivery of the nutrients to the wrong organ.
Other risks of NG tube feeding may be discomfort, nosebleeds or sores. In rare instances, it may cause trauma or pierce the oesophagus or stomach.
Some problems with bleeding may occur with those bleeding disorders or who take blood thinners.
How often should I change the feeding tube?
With careful maintenance, an NG tube can stay in place for up to 6 weeks without needing replacement. However, it depends on the material of the tube. PVC tubes can last for a maximum of two weeks while polyurethane tubes can be used for up to 6 weeks as it is unaffected by gastric acid.
How do I lower the risk of complications?
Proper care of the NG tube means ensuring the proper placement of the tube. This can be done by taking a small content sample from the NG tube and checking the pH levels. Acidity levels can indicate whether or not the tube is really in the stomach. This is important because misplacement of the tube or if the tube is not fully inserted can cause liquids to be administered in the lungs. Keep in mind that displacement can also occur if you have been coughing or retching.
Keeping the environment clean and washing hands is important to lower the risks of complications. Regularly flush the tube clean with water to free it from obstruction before you reinsert tube.
Some medicine can be administered using the NG tube. Ask your doctor or pharmacist for the best forms of medication that can go through your NG tube as some tablets can be crushed and mixed with water and through NGT while others should not be crushed.
Maintaining Oral & Tube Hygiene
For those who can eat and drink, they should maintain good normal oral hygiene: brush teeth and stay hydrated.
Meanwhile, those who cannot eat or drink should be mindful of mouth ulcers and fissures. To avoid these, the delicate tissues of the mouth should be kept moist.
To keep your NG tube clean, flush it with clean water before and after every feed to ensure it is not clogged with food or medicine.
NGT Care at Home
NG tube is a solution for ongoing needs, whether short term or long-term. It is helpful to know how to care for your own NGT and ensure its proper placement and care. It is also a good idea to have caregivers and nurses who are skilled in NG tube care, an integral part of elderly care in Singapore.
Nursing agency Singapore can provide trained caregivers and nurses who are not only knowledgeable in the maintenance of an NG tube but also can assist with other care needs of the elderly. May it be medication management or assistance with activities of daily living, you can enlist the help of care providers to ensure the health and well being of your loved one.