Gastric Gavage(Tube) Feeding Procedure

1. Confirm patient’s identity using two patient identifiers according to your

facility’s policy.
2. Verify physician’s order.
Tube feedings MUST be ordered by a physician. The order will indicate the
type of formula to be used, route, amount to be administered and frequency
of feeding.
3. Provide privacy and explain the procedure to the patient.
4. Place a towel or linen-saver pad on the client’s chest to protect him from
spills.
5. Position the patient in a high-Fowler’s position (30 to 45 degrees). Inform
the patient to remain in this position during and 1 hour after feeding to limit
the risk of aspiration and reflux.
6. Wash hands and don gloves.
7. Assemble equipment.
8. Check the placement of the feeding tube to verify the correct placement of
the tube in the stomach. NEVER administer a tube feeding until you are sure
the tube is properly positioned in the stomach. Administering feeding
through a misplaced tube can cause the formula to enter the lungs.

o To check tube patency and position, remove the cap or plug
from the tube feeding and use a syringe to aspirate stomach
contents. Examine the aspirate and place a small amount on
the pH test strip. The tube is patent if the aspirate has a pH of
5.0 or less. If pH is higher, do not proceed to feed, inform the
physician as the tube may be displaced. Another way to check
the placement of the tube is by obtaining an x-ray film for
tube placement.
o NOTE: In the past, insufflation of air into the tube was
followed by auscultation of abdominal sound. This technique is
no longer considered reliable in determining the placement of
the tube.
9. Assess gastric emptying by aspirating and measuring residual gastric
contents. If the residual volume is greater than 150ml or the
predetermined amount specified in the physician’s order, hold feedings.
Reinstill any aspirate obtained.
10. Observe the abdomen for distention to assist in recognizing delayed
gastric emptying and decreases the risk of regurgitation and pulmonary
aspiration due to gastric distention.
11. Auscultate abdomen for bowel sounds to check the presence of peristalsis
and ability of GI tract to digest nutrients.
12. Administer tube feeding.

o Bolus or intermittent feeding: (a) Pinch the proximal end of
the feeding tube to prevent excess air from entering the
patient’s stomach, causing distention. (b) Attach the syringe
to the end of the tube and elevate it 18 inches above the head
of the patient. (c) Pour the formula into the syringe. Allow the
syringe to gradually empty. Refill syringe until the ordered
amount has been consumed.
o Continuous-drip method: (a) Hang gavage bag to an IV pole.
The patient should be checked every 6-8 hours. (b) Connect
the end of the bag to the proximal end of the feeding tube. (c)
Connect the infusion pump and set the rate.
13. Flush the tubing by adding 60 ml of water to the gavage bag or bulb
syringe, after administering the prescribed amount. This maintains tube
patency by removing excess formula which could occlude the tube.
14. Cover the end of the feeding tube with its plug or cap or clamp the
proximal end of the feeding tube to prevent leakage and contamination of
the tube.
15. Remove and dispose of gloves in a proper receptacle.
16. Document time, amount and type of feeding.
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Tiffany Luv B. Adrias

BSN IV - King