ORO/NASO-GASTRIC TUBE INSERTION,FEEDING AND REMOVAL

1. Verifies physicians orders.

2. Identifies the client ( newborn)
3. Performs proper handwashing.
4. Prepares and assembles needed materials on a tray and brings to bedside. Warm's milk/feeding to
room temperature if necessary
5. Explains the procedure and its purpose to the clients primary care giver.
6. Using the feeding tube , correctly determines the length of tubing needed to ensure placement in the
stomach.(tip of the nose to the tip of the earlobe to the xyphoid process
7. Mark the appropriate distance on the tube with a piece of tape or with a pen.
8. Properly positions the newborn ( supine,tilted slightly to the right, head and chest slightly elevated)
9. Properly don sterile gloves
10. Stabilize the newborn head with one hand and lubricate the feeding tube with sterile water with the
other hand.
11. Insert the tube smoothly and quickly up to the pre-measured tape mark.
-Oral insertion: Passes the tube toward the back of 
the throat.
12. Insert the tube smoothly and quickly up to the pre-measured tape mark.
-Nasal insertion: passes the tube toward the occiput
in a horizontal plane.
13. Assess the client for any sign that the tube has entered the trachea and signs for vagal stimulation.
14. Attach 5 cc syringe at the open end of the feeding tube.
15. Check the placement of the feeding tube in the stomach.
-Aspirate residual stomach contents with the syringe; notes volume obtained, characteristics and ph of
content and re inject it.
16. Inject 0.5 to 1 ml of air in the tube while listening with the stethoscope for air sound in the stomach
and on each side of the anterior chest.
17. Remove the 5 cc syringe ( when correct placement of the feeding tube has been confirmed).
18. Connect the asepto /feeding syringe to the top of the tube and fills it with milk/feeding .
19. Start the feeding , holding the feeding syringe 6 to 8 inches above the newborn head.
20.Regulate the flow of feeding to 15 to 20 minutes.
21. When the feeding is finished , pinch the tube before air enter the newborn stomach.
22. If the feeding tube remain in place: a. Flush several cc of sterile water ( if ordered)
23. Tape / anchor the tube flat on the newborn cheek
24. Kink the end of the feeding tube with a piece of tape
25. If the feeding tube is to be remove, with draw the tube smoothly and quickly.
26. Burp the newborn
27. Position the newborn on the right side for 1 hour after feeding.
28. Perform complete after care
29. Document the procedure