OG Insertion
- 1. INSERTION OF OROGASTRIC TUBE & ORO- GASTRIC TUBE FEEDING BIJAYLAXMI BEHERA
- 2. PURPOSE 1. Insertion of feeding tube: For infants who - Require gastric decompression - Require gastric lavage 2. Oro-Gastric tube feeding: For infants who -Are unable to feed orally and need continuous or intermittent gavage feeding e.g. preterm,VLBW infants, neurologically depressed. -Neonates with surgical conditions -Neonate on CPAP /Ventilation
- 3. EQUIPMENT 1. Feeding tube • a. 6 FG for babies >2000g • b. 5 FG for babies< 2000g 2. Appropriate size syringe 3. Stethoscope 4. Scissors 5.Tape
- 4. PROCEDURE 1. Wash hands thoroughly. 2. Position baby on right side or in supine position with head elevated. 3. Measure the length required for insertion: - Open the feeding tube package and starting at the tip of the tube, - Measure from the bridge of the nose to the tip of the ear lobe down to tip of xiphoid process - Measure from tip of nose to tip of ear lobe and midpoint between xiphoid and umbilicus. - Mark the tube with tape or maintain measurement with thumb and finger
- 5. PROCEDURE 4.To insert an oro gastric tube: - -Hold the feeding tube 1" - 2" from the tip -Use the natural bend of the tube to follow the natural curves of the mouth and throat -Insert the tube in the mouth and towards the back of the throat, gently pushing it down the esophagus until it reaches the pre-measured mark on the tube 5. Establish correct placement of the feeding tube by either of the following methods: -Connect the syringe to other end of feeding tube and gently aspirate the contents. - The aspiration would look like curdled milk, if the tube is in stomach
- 6. • Disconnect syringe from the feeding tube and draw up 1-2 cc air. • Reconnect the syringe to the tube. • Inject the air into the stomach while auscultating. You should hear the air enter the stomach. • Gently aspirate air before commencing feed 6. Observe baby for choking, gasping or cyanosis during insertion of tube. Withdraw tube immediately if baby appears to be in any distress. 7. Tape the tube in place at angle of mouth. PROCEDURE
- 7. PROCEDURE FOR GIVING ORO-GASTRIC TUBE FEEDING
- 8. 1. Wash hand remove the plunger of a 10, 20 or 50 ml sterile syringe. 2. Connect the barrel of the syringe to the end of the gastric tube. 3. Fill the barrel with the required volume of milk. 4. Let the milk run from the syringe through the gastric tube by gravity. DO NOT force milk through the gastric tube by using the plunger. 5. Hold the syringe 5-10 cm above the infant until the syringe is empty. 6. It should take about 10-15 minutes for the milk to flow into the infant's stomach. • Changing the height of the syringe will also affect the speed of milk flow. • Lowering the syringe slows the milk flow, raising the syringe makes the milk flow faster.
- 9. 7. Observe the infant during the entire gastric tube feed. Do not leave the infant unattended. 8.Stop the tube feed if the infant shows any of the following signs: a. Breathing difficulty b. Changes colour, looks blue c. Becomes floppy d. Vomits 8. Cap the end of the gastric tube between feeds. 9. Keep open the tube end after 30 minutes of feed if baby on CPAP. 10. Document the feed amount on the clinical monitoring chart.
- 10. POINTS TO EMPHASIZE • Pass the gastric tube gently so as to avoid trauma • Passage of the gastric tube may lead to stimulation of vagal nerve resulting in apnea or bradycardia. • If this occurs, tactile stimulation will assist the infant to breathe. • Let milk flow under gravity. • Pinch tube while filling the syringe • Feed slowly • Pinch the tube during removal