Care of nasogastric tube

A nasoenteric tube is a medical device whose main material is an X-ray-opaque polyurethane tube. It is mainly used to help the intestines move. When a person's gastric motility is normal, the nasoenteric tube can directly provide the human body with some nutrients with the help of an endoscope, thereby reducing the increase of internal bacteria or the transfer of their position, while also protecting the intestines from damage. So what kind of care is needed after each use of a nasogastric tube?

1. Keep the oral cavity clean and provide oral care twice a day. To prevent aspiration, the head of the bed should be raised 30-45 degrees. Use a special nutrition pump for infusion and clear oral secretions in time to keep the oral cavity clean.

2. Before each infusion of nutrient solution, check the length of the nasogastric tube left outside to prevent the nasogastric tube from slipping. And check the gastric retention. The specific detection method is: you can aspirate the gastric contents. If there is gastric retention when there is 100 ml of gastric content 2 hours after the last feeding or about 50% of the feed remains in the stomach after 1 hour, you should stop the nutrient solution input immediately and change the feeding route or feeding method according to the situation.

3. Before and after each use, flush the pipe with at least 20 ml of sterile water or warm water to check whether it is unobstructed. For patients who are receiving continuous enteral nutrition, the tube should be flushed every 6 to 8 hours. For viscous nutrients, the number of flushing times should be appropriately increased.

4. For patients who need to take oral medications through a nasogastric tube, the specific method is: first grind the drugs separately, fully dissolve and dilute them, then suspend the enteral nutrition pump, rinse the nasogastric tube with 20 ml of warm water, inject the dissolved drugs into the nasogastric tube, and then rinse the nasogastric tube with 20 ml of warm water after injecting the drugs, turn on the enteral nutrition pump, and record the amount of medicine and water on the special care sheet.

5. Closely observe the patient for abdominal pain, bloating, diarrhea, etc., and pay attention to the amount, color, and quality of stool.

6. Observe the therapeutic effect and record the intake and output for 24 hours. Monitor electrolytes, liver and kidney function, blood lipids and blood sugar, and urine routine regularly as directed by the doctor.

7. Special enteral nutrition solution must be used for feeding, such as in-hospital nutrition meals, TPF, etc. It is prohibited to use homemade nutrition solution by family members to prevent blockage of the tube.

8. Problems that may arise during enteral nutrition feeding include:

① Aspiration caused by improper feeding

② Gastric retention

③ Feeding tube obstruction

④ Mechanical stimulation caused by nasal tube leads to damage to nasopharynx and esophagus

⑤ Feeding tube displacement and dislocation

⑥ Gastrointestinal reactions: abdominal distension, diarrhea, nausea, vomiting, etc.

9. Methods to prevent feeding tube blockage: (2 2 1) 2--Flush the tube every two hours 2--Flush the tube with 20 ml of warm water 1--Check once every hour.

10. How to deal with pipe blockage:

First flush: Use 20ml of warm water to flush the tube with an empty needle

Second draw: Use an empty needle to draw out as much nutrient solution as possible from the tube. Third push injection: Use sodium bicarbonate or cola to push as much as possible into the tube. Fourth wait: Wait for 30-60 minutes.

Repeat five times: If it doesn’t work, continue to repeat the above steps

Note: If the flushing fails for two consecutive times, report to the doctor before proceeding. (Do not use a guide wire)