What is the best position for the client for administration of the bolus tube feedings?

Video Guides

OWN YOUR FEEDING TUBE: A five-part video series with Gunnar Esiason.

THE FIRST DAY HOME WITH YOUR FEEDING TUBE.

In this “How-To” video, you will see how you can use your feeding tube in different situations. Both bolus feedings and pump-assisted feedings are discussed. You will also see how all feeding tube systems are changing to the ENFit™ connector system. In 2016, feeding tubes and tube feeding supplies will transition to the ENFit™ connector system, which is designed to improve tube feeding safety.

WHAT CAN I EXPECT FROM MY FEEDING TUBE?

The video will show you a few lifestyle changes you may experience after you have had a feeding tube placed. It can seem like a lot of work and a little overwhelming at first, but once a working routine is developed, the benefits from a feeding tube may result in an improved lifestyle. Among some of the changes discussed are establishing new feeding habits, changes in sleep patterns, and day to day life.

NORMALCY WITH THE FEEDING TUBE.

In this video, you will see how those who require a feeding tube are still able to maintain a physically active lifestyle. Prior to the placement of the tube, it is not uncommon to question how your life may change. It’s important to remember that by receiving adequate nutrition with a tube feeding regimen, health conditions may improve and there may be an increase in energy and activity levels. While there are added responsibilities of taking care of a feeding tube and maintaining a good routine, a little hard work can go a long way for incredible gains.

COMFORT WITH YOUR FEEDING TUBE.

This video discusses some of the social questions and issues that may arise as a result of having a feeding tube. It is a noticeable device, and often people will need to overcome the appearance of the feeding tube. It is a challenge that can be beaten, as here you will see how one person has thrived socially, athletically, and professionally despite his medical condition and the need for a feeding tube.

SUCCESS WITH THE FEEDING TUBE.

In this video, you will see how a feeding tube has made a difference over a several year timeframe. A person can remain on a feeding tube for as long or as short amount of time as needed. Some people keep their feeding tubes for extended periods of time, allowing them to continue to receive their nutritional requirements and experience the benefits of both gaining and maintaining weight. Further, you will see how the extra nutrition gives one person with a feeding tube an improvement in both energy and overall health.

Types of Feeding Tubes

NASOGASTRIC (OR NG TUBE)

The feeding tube passes through the nose,down the throat and esophagus and ends in the stomach.

NASOINTESTINAL (OR NI TUBE)

The feeding tube passes through the nose, throat and esophagus, continues through the stomach, and ends in the first section of the small intestine.

GASTROSTOMY (OR G TUBE)

The feeding tube is inserted directly into in the stomach.

JEJUNOSTOMY (OR J TUBE)

The feeding tube is surgically inserted into the jejunum, the middle section of the small intestine.

Comprehensive Guides

Follow the specific instructions provided by your health care provider, as these are based on the location of your tube.

TUBE FEEDING WITH A SYRINGE (BOLUS)

Before starting, follow your healthcare professional’s instructions to check the position of your tube before you begin a feeding.

Supplies

1. Clean measuring cup with pour spout
2. Formula (room temperature)
3. Syringe (60 mL)
4. Water (room temperature)

Preparation

1. Wash hands thoroughly.
2. Rinse the top of the formula container with hot water or wipe with clean wet paper towel.
3. Shake formula container well before opening.
4. Use syringe to flush feeding tube with water, as directed, by your healthcare professional.
5. Pour formula into clean measuring cup or directly into the syringe.

Administration

1. Sit or lie with your head elevated at least 30 degrees (about the height of two pillows) and remain in this position for 30 to 60 minutes after each feeding to help prevent nausea or reflux.
2. Open (unclamp or uncap) feeding tube.
3. Fill syringe with formula and attach to feeding tube. Release feeding tube to allow formula to flow.
4. Raise or lower height of syringe to increase or decrease flow (feeding) rate.
5. If indicated, add more formula to syringe as formula flows into feeding tube.
6. After feeding, use syringe to flush feeding tube with water, as directed by your healthcare professional.
7. Detach syringe from feeding tube and close (reclamp or recap) feeding tube.

TUBE FEEDING BY GRAVITY

Supplies

1. Feeding container and tubing (gravity set)
2. Formula (room temperature)
3. Pole
4. Syringe (60 mL)
5. Water (room temperature)

Preparation

1. Wash hands thoroughly.
2. Rinse the top of the formula container with hot water or wipe with clean wet paper towel.
3. Shake formula container well before opening.
4. Use syringe to flush feeding tube with water, as directed, by your healthcare professional.
5. Pour formula into feeding container and close cap.
6. Hang feeding container on pole so it is at least 18 inches above stomach.
7. If using a pre-filled feeding container, shake and connect as directed.
8. Open clamp on flow regulator until the formula fills the tubing.
9. Close clamp on the flow regulator.
10. Make sure drip chamber on the tubing is about half full.

Administration

1. Sit or lie with head elevated at least 30 degrees (about the height of two pillows) and remain in this position for 30 to 60 minutes after each feeding to help prevent nausea or reflux.
2. Open (unclamp or uncap) feeding tube.
3. Connect tip on the end of gravity set into feeding tube.
4. Open flow regulator clamp to adjust flow rate, as directed by your healthcare professional.
5. After feeding, close and disconnect gravity set from feeding tube.
6. Use syringe to flush feeding tube with water, as directed.
7. Close (reclamp or recap) feeding tube.

TUBE FEEDING WITH A PUMP

Supplies

1. Enteral feeding pump
2. Feeding container and tubing (pump set)
3. Formula (room temperature)
4. Pole
5. Syringe (60 mL)
6. Water (room temperature)

Preparation

1. Wash hands thoroughly.
2. Rinse the top of the formula container with hot water or wipe with clean wet paper towel.
3. Shake formula container well before opening.
4. Use syringe to flush feeding tube with water, as directed by your healthcare professional.
5. Pour formula into feeding container and close cap.
6. Hang feeding container on pole so it is at least 18 inches above stomach.
7. If using a pre-filled feeding container, shake and connect as directed.
8. Follow instructions provided to set up and operate pump.

Administration

1. Sit or lie with head elevated at least 30 degrees (about the height of two pillows) and remain in this position for 30 to 60 minutes after each feeding to help prevent nausea or reflux.
2. Open (unclamp or uncap) feeding tube.
3. Connect tip on the end of pump set into feeding tube.
4. Set flow rate on pump to recommended mL per hour.
5. If applicable, open roller clamp on pump set.
6. Start the pump.
7. After feeding, disconnect pump set from feeding tube and recap end of pump set.
8. Use syringe to flush feeding tube with water, as directed by your healthcare professional.
9. Close (reclamp or recap) feeding tube.

PERSONAL CARE AND HYGIENE

It’s always important to maintain good oral health. The following steps are recommended to help keep your mouth as clean as possible. Follow any other special instructions from your healthcare professionals. If you have a gastrostomy or jejunostomy tube, care of the skin surrounding the feeding site is very important.

Mouth:

• Brush teeth, gums, and tongue at least two times a day using toothpaste and a soft toothbrush.
• To moisten mouth, if allowed, use ice chips, hard candies, or chewing gum.
• Freshen mouth and breathe by using mouthwash.
• To moisten lips, use lip balm or lanolin-based moisturizing cream.
• To prevent chapping, avoid licking lips.
• Report bleeding or anything unusual to your healthcare professional.

Nose:

1. If you have a nasogastric or nasointestinal tube, it is important to take care of your nose as the tube may cause mild soreness or mucus in your nostrils.
2. On a daily basis, change tape holding feeding tube in place. When re-taping, allow some slack so the tube does not rub against nostrils.
3. Clean nostrils at least once a day with a soft washcloth or cotton swabs moistened with warm water.
4. Remove sticky tape residue with a special adhesive remover.
5. Remove crusting on nostrils with warm water or on a cotton swab.
6. Report any redness, bleeding, numbness or anything unusual to your healthcare professional.

Administration

1. If you have a gastrostomy or jejunostomy tube, care of the skin surrounding the feeding site is very important.
2. Wash hands thoroughly.
3. Cleanse the skin around the tube daily with soap and warm water as directed by your healthcare professional.
4. Check the tube site every day for signs of redness, soreness, swelling, foul smelling odor, or unusual drainage.
5. Report anything unusual to your healthcare professional.
6. Dry the skin around the feeding tube site thoroughly. Healed gastrostomy or jejunostomy sites usually do not need a special dressing. If a dressing is required, follow the instructions from your healthcare professional.

ADMINISTERING MEDICATIONS

Medications may be needed to help keep your body healthy. The following provides directions for administering medication through your feeding tube. Follow your healthcare professional’s instructions for taking your medication. Use liquid medications whenever possible. If using pills, crush medications into a very fine powder and dissolve in water.

Check with your nurse, doctor, or pharmacist to get specific instructions on:

• How to crush medications
• How much water to mix with your medication
• Which medications should not be crushed
• Which medications should not be given together
• Medications that need special considerations when given through a feeding tube

Even though your tube feeding formula contains water, extra water may be required for proper hydration and to prevent clogging of your feeding tube. Follow your healthcare professional’s instructions for flushing your feeding tube before and after medications and feedings.

Instructions

1. Using a 60 mL or larger syringe, rinse or flush feeding tube with 15-30 mL of warm water before administering medication (unless instructed otherwise by your healthcare professional). Do not force the water flush. If you have difficulty flushing your feeding tube, contact your healthcare professional.
2. Using a 60 mL or larger syringe, draw up correct dose of medication. Open feeding tube and connect syringe into feeding tube.
3. Gently push water and medication into tube. When administering water only, you may remove plunger from syringe and allow water to flow in by gravity.
4. Remove syringe from feeding tube and refill syringe with warm water as needed until desired amount of water is given, or to flush all medication from the syringe.
5. Close (reclamp or recap) feeding tube and recap syringe.

Printable Quick Start Guides

TUBE FEEDING OVERVIEW

Start here to learn about tube feeding at home.

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MEDICATIONS THROUGH A FEEDING TUBE

Learn how to take medications through your feeding tube.

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PERSONAL CARE & HYGIENE

Learn some typical tube feeding hygiene tips.

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HOW TO ADMINISTER TUBE FEED FORMULA THROUGH A FEEDING TUBE

Learn how to feed yourself through your tube.

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What is the best position for bolus tube feeding?

What is the recommended position for patients receiving tube feeding and why?

What is the best and comfortable position of the patient during tube feeding?