Description
Tubes placed in the stomach are commonly referred to as feeding tubes, gastrostomy tubes or peg tubes. Surgically incisions are made into the abdomen and tubes are placed which allow nutrients “feeding” to be put directly into the stomach.

We will review the tube feeding procedure, how to perform insertion site care, and ways to prevent possible complications.

Task time
15-45 minutes

The Tube Feeding Procedure

1. Wash your hands for 15 seconds with soap and water
2. Sit the individual in an upright position, using pillows or bed/chair positioning if available
3. Check that the feeding solution is within the safe use date
4. Unclamp the tube and attach appropriate syringe. Pull back on plunger to see if there is any residual stomach contents left from the previous feeding. (This determines whether or not the person is digesting the feedings). If there is more than 50ml residual stomach contents, hold the feeding and seek directions from your physician
5. If less than 50ml residual stomach contents are left, remove the inner plunger of the syringe (or the bulb n a bulb syringe) and pour the feeding into the barrel of the syringe. The feeding will flow from the syringe into the feeding tube itself and will take approximately 10-20 minutes depending on the amount of feeding ordered. (If using a feeding bag, pour the feeding into the bag, set the rate as instructed and hang the bag as directed.)
6. When the feeding is completed, pour water into the syringe (or bag) to flush the syringe (or bag) and tube
7. Remove the syringe (or bag) and clamp the tube securely
8. Keep the individual in the upright position for at least 30 minutes after the feeding
9. Wash the syringe (or bag) with soap and water, rinse with water and dry thoroughly. (*Syringes may also be cleaned in a dishwasher)

Care of the Insertion Site

1. Wash the site where the feeding tube enters the body (the insertion site) with soap and water at least daily and more if discharge/crusting is found. Dry thoroughly with soft towel
2. Apply protective skin creams/ointments as directed and instructed
3. Apply dressings only as directed and instructed

Prevent Possible Complications

• Tube Clogging -- Always rinse after feeding with water
• Choking/Vomiting -- Always position the individual upright during and after feeding
• Observe for diarrhea/constipation/vomiting -- Notify the physician immediately of any GI (gastrointestinal) upset/changes as this may be a side effect of the feeding formula, and a change in formula may be needed, or of other GI complications
• Monitor urinary output -- If urine changes in color, amount or odor, notify the physician immediately as this may be a sign of dehydration or other urinary complications

Important Points to Consider

• Some people require tube feedings because it is unsafe for them to try and swallow food or fluids by mouth.
• Some people receive tube feedings because they are not consuming enough food and fluids by mouth. It is imperative that you understand the reason for the feeding tube, and only give the individual the food and fluids by mouth as directed by your physician.
• Some feeding tubes require routine replacement by qualified staff, know what type of feeding tube placed and what/if there is a schedule for replacement.
• Even though the individual may be receiving tube feedings, gentle oral cares will still need to be performed. Use only soft toothbrushes and oral swabs available for this task. Consult your Dentist for further care instructions/guidance.
• Secure the feeding tube with a wide strip of soft cloth so that there is no pulling or accidental removal during times of activity such as transfers or repositioning (avoid tape as it can be irritating to the skin over a period of time).
• Keep adequate supplies of all equipment and feeding needed, and have a supplier and system for replacement.