There are some factors which should be carefully considered when determining if someone is suitable for NG feeding.
None of these apply to Bill and he will have his NG tube passed this afternoon.
NB: Practitioners must be competent in placing a NG tube (and nasal bridles if applicable).
Severe Coagulopathy: This is any condition where the blood’s ability to coagulate (to form clots) is impaired. The introduction of a NG tube could cause prolonged or excessive bleeding. Advice should be sought before proceeding. People with these conditions would need regular observations (NEWS) carried out post procedure.
Agitation: If the person is agitated then look for a cause. They may become more distressed due to the procedure and/or lack awareness of the need for the NG tube. Involving family may help. The tolerance of the NG tube or the chance of it being dislodged should be considered before the administration of any feed or medicines.
Severe Trauma / base of skull fracture: There is a chance that the NG tube could be intracranial. This is likely to be a LETHAL COMPLICATION. Blind insertion is contraindicated to the risk of intracranial passage. It is therefore recommended that ENT should be consulted and the NG tube only inserted with endoscopic or radiological guidance.
Ethical: When a person has a life threatening stroke or other complications NG feeding should be with-held until after discussion with the next of kin / Power of Attorney. The person may also have an advanced directive that has clear instruction. This should be discussed on an individual basis.
Non-functioning GI system: In people with a bowel obstruction, bowel perforation or paralytic ileus NG feeding should not be commenced. If already in place it should be stopped until bowel sound/ function is restored. Abdominal distention may comprise their respiratory function/breathing.
Page last reviewed: 02 Jun 2021
