Flushing
Flushing of the tube is essential for 2 very important reasons:
Tube patency – Regular flushing of fine bore NG tube is important to maintain tube patency. This may be a patients sole access point for fluid/ medications. Fine bore tubes can block easily and require regular flushes.
Fluid volume – The regimen for feeding may be arranged to allow sufficient fluid to be administered. This takes into account flushes between bottles and with frequency of medications.
Troubleshooting and Tolerance Issues
Monitor for signs of poor tolerance of the feed and discuss these with the dietitian, prior to alteration of feed regimen. Symptoms may be related to other reasons, e.g. infection, underlying health conditions, medications, rather than feeding regimen.
| Symptom | Influencing factors | Possible Intervention |
| Nausea
Vomiting Reflux Abdominal pain Abdominal distension Diarrhoea Constipation
|
Polypharmacy (sorbitol)
poor hygiene practices suboptimal method of feeding e.g. pump or bolus timing of feed, e.g. day or night hourly feeding rate medications vertigo movement feed temperature change in position of NG tube/tube migration fibre content of feed concentration of feed volume of feed volume of water flushes incorrect fluid balance
|
Review Medications
Ensure good hygiene practice is followed when connecting/disconnecting feeds Do not use feed bottle for >24 hours once opened Confirm NG position Ensure feed at room temperature Change method of feeding Change timing of feeding Change rate of feeding Change fibre content of feed Change concentration of feed Change feed volume Change water flushes Stop feed prior to movement/therapy input |
Any changes to feeding regimes, should only be done following MDT discussion with dietitian.
https://www.bapen.org.uk/nutrition-support/enteral-nutrition/complication-management
Page last reviewed: 22 Jul 2021
