#QFEED FOR TUBE FEEDING NARES HOW TO#

Place a tape marker on the tube once the appropriate measurement has been taken. It is the author's recommendation that the feeding tube not pass through the lower esophageal sphincter, as this may result in sphincter incompetence and esophageal reflux of hydrochloric acid, causing esophagitis. Tube placement: Select an appropriate size feeding tubeĮstimate the length of tube to be placed in the esophagus or stomach by placing the tube from the nasal planum along the side of the patient to the 7 or 8th intercostal space (i.e., nasoesophageal) or last rib (i.e., nasogastric). If the patient does not tolerate passage of the tube, sedation or light general anesthesia may be required. Repeat application of local anesthetic before attempting to pass the nasoesophageal/ nasogastric tube. If the patient will not tolerate nasal intubation (i.e., if excess stress is required to place the nasoesophageal/ nasogastric tube particularly with debilitated cats), administer 1 to 2 mg/kg of ketamine intravenously to obtain light general anesthesia.Īnesthesia-dog : Place 1 to 2 ml of 2% lidocaine into the nasal cavity and tilt the head upwards for several seconds. Repeat application of local anesthetic to ensure adequate anesthesia of the nasal mucous membrane. Tilt the head up to encourage the local anesthetic to coat the nasal mucosa.

In the majority of cases, topical anesthetic or light sedation is all that is necessary for proper tube placement.Īnesthesia-cat : Place 0.5-1 ml of 0.5% proparacaine hydro-chloride (topical local anesthetic) into the nasal cavity. Technique : Local nasal anesthesia, sedation, or light general anesthesia may be necessary for placement of a nasoesophageal/ nasogastric tube in dogs and cats. Nasoesophageal/ nasogastric tube placement is indicated in any patient with protein-calorie malnutrition that will not undergo oral, pharyngeal, esophageal, gastric, or biliary tract surgery. The availability of small bore, soft polyvinyl and silastic feeding tubes (i.e., 3-5 French 36 inch, Argyll or National Catheter Company) and low viscosity, nutritionally complete liquid diet formulations, and patient tolerance of tube placement has made nasoesophageal/ nasogastric tube placement a popular avenue for feeding malnourished patients. Nasoesophageal/ nasogastric intubation is an easy, effective, and efficient means of providing enteral nutritional support. Each route has its indications, contraindications, advantages, disadvantages, and complications. The most common routes of administration for enteral hyperalimentation include oral, nasoesophageal/ nasogastric, pharyngostomy, esophagostomy, gastrostomy, gastroduodenostomy, and jejunostomy. Route of administration also dictates feeding tube diameter tube diameter in turn dictates usable feeding formulas due to varying formula viscosity and particulate matter size. Conversely, the further aboral one gets, the less efficient is the assimilation and digestion of nutrients and greater care must be taken when choosing formula composition. Keep a column of water in the tube between feedingsĪs a general rule, the closer one comes to the oral route of food intake and digestion, the more efficient is the assimilation and digestion of nutrients and the greater the flexibility in formula composition.

#QFEED FOR TUBE FEEDING NARES HOW TO#

Learn how to do a Chinese finger trap friction suture Books & VINcyclopedia of Diseases (Formerly Associate)įeeding tubes should not pass the LES (lower esophageal sphincter).VINcyclopedia of Diseases (Formerly Associate).This technique has been successfully carried out in 22 consecutive patients, thereby avoiding the use of more invasive methods. The tube is then advanced into the esophagus while the patient is vocalizing. The feeding tube is inserted through the appropriate nasal cavity, and at 21 cm (8 inches) from the anterior nares in the average adult (corresponding to a few millimeters above the arytenoids), the patient is asked to vocalize by saying 'eeeee' in a high pitched tone. In this paper, we describe a simple technique that evolved from experience of passing enteral feeding tubes in head and neck cancer patients. Nasogastric intubation in head and neck cancer patients may be especially difficult following radiotherapy due to difficulties in swallowing secondary to edema, mucositis, abnormal anatomy and altered sensation. Various techniques of insertion have been described emphasizing the fact that as yet there is no simple and safe method.

Nasogastric tubes are increasingly used in the management of a diverse group of patients who generally require short-term enteral feeding.

Qfeed for tube feeding nares