Adults

Before the NG-Tube is placed, your care team will explain what is going to happen, why, and what to expect. You’ll need to give verbal consent to have the tube placed.

It’s always good to have a loved one around during the tube placement for moral support. If you are a caregiver of the adult getting the tube, and you know your loved one can sometimes be a little uncooperative, you might be called on to help hold them during the placement.

You or your carer may be taught how to place the tube during the procedure.

If it is safe for you to drink, the nurse may ask at a certain point to sip water from a straw to help the tube pass more easily into the stomach.

The nurse will determine how far to place the tube by measuring the length from nose to the tip of the earlobe to the midpoint between the breastbone.

Before the placement begins, the tube will be dipped in water or lubricating jelly to make it more comfortable to pass. The nurse may ask you to tilt your head slightly forward, as this may help the tube pass more easily through the nose and throat. Gagging may occur, this can be uncomfortable but this part of the tube placement is very quickly over.

Afterwards, a nurse will teach you or your carer how to confirm that the tube is placed correctly in the stomach. Placement will be checked by taking some gastric fluid out with a syringe and testing on pH Indicator paper (or sometimes x-ray) to make sure the tip of the tube is in the stomach. If the tube had a stylet, after confirmation the tube will be flushed with water and the stylet removed. The tube will then be taped onto the cheek or nose. The tube has measurement marks every 1cm, your nurse should record what cm mark the tube is at your nose so they can see if it has moved from the correct position.

It’s normal to have some discomfort at the nostril and or back of the throat at first. Eventually that feeling with decrease as you get more used to the tube. Positive thinking is very beneficial during this stage. Remind yourself or your loved one frequently that many people have done this successfully and you/they can too. Good words of self-encouragement are: “I can do this! I am going to do this!

The staff will teach you how to set up the feed and run the pump. If a pump isn’t used, you’ll be taught how to give feeds without one using a syringe for bolus delivery.

Frequent toothbrushing and good oral hygiene is very important to keep the mouth clean and moist. You’ll also want to ask if it’s OK to sip water and eat food if oral intake is possible.

Before you leave your Dietitian, Nurse or Homecare provider will make sure you have all that you need to continue to use the tube at home. Make sure you have all your questions answered and an emergency contact for management at home.

The first thing you’ll want to do when you get home is find a place to store your supplies. You’ll also want access to a clean space where you can prepare the formula. Your dietitian, nurse or homecare company will advise you and arrange for your ongoing supplies before leaving hospital.

You will have been advised to check the tube several times a day to make sure it hasn’t moved, before each time you use the tube to feed or give medication with a pH test (you will be shown how to do this before leaving hospital). If you ever have any doubts about tube position, don’t use the tube and seek advise from your homecare professional.

Also remember, that even if you are not eating or taking medication by mouth, oral care is still very important. Frequent toothbrushing or using oral swabs are necessary to clean and keep the mouth moist.

Refer to your notes or discharge information as you get started.

Remember: the first day at home after any big change is going to require some adjustment. But before long, you’ll become more used to what to do and how to do it and you’ll develop a new routine that’s second nature to you. One more tip: in some cases, you’ll need to give medications down the NG-tube. If so, ask if the medicine needs to be diluted first. You’ll also need to flush the tube before and after giving the medicine and feeding to prevent clogging.