Nasogastric Tube Care at Home

Insertion, Removal, and Flushing

Our professional nurses provide home care services for patients with a nasogastric tube (NG tube), including practical support for insertion, care, flushing, and removal.

Nasogastric tube insertion must be performed by qualified medical personnel, such as a nurse or doctor.

Nasogastric Tube Insertion — Step by Step

Hand Hygiene

The procedure begins with proper hand hygiene and the use of gloves.

Patient Positioning

The patient should be placed in a sitting or semi-sitting position at a 45–90° angle.

Required Materials

  • NG tube of the appropriate size
  • Lubricant
  • 20–50 ml syringe
  • Sterile water
  • Tape or fixation device
  • Towels or protective pads
  • Gloves

Measuring the Tube Length

NEX Method

Measure the tube from:

  • The tip of the nose
  • To the earlobe
  • To the right upper abdominal area below the ribs

Mark the tube at this measured point.

Insertion Procedure

  1. Lubricate the tube.
  2. Gently insert the tube through the nose.
  3. When the tube reaches the level of the throat, ask the patient to swallow.
  4. Slowly advance the tube to the marked point.

The procedure must be stopped immediately if any of the following signs appear:

  • Coughing
  • Difficulty breathing
  • Cyanosis
  • Severe pain

Confirmation of Tube Placement

Confirmation of correct tube placement is essential.

This may include:

  • Injecting air with a syringe and listening over the epigastric area with a stethoscope
  • Aspirating gastric contents and checking the pH level
    pH < 5 usually indicates correct placement
  • Visual assessment

After confirming proper placement, the tube is secured externally to the nose.

Home Care for a Patient with a Nasogastric Tube

Daily Check of Tube Fixation

  • The tape should not be wet.
  • The tube should not move back and forth.
  • The tube position should be checked regularly.

Skin Care

  • Clean the area around the nose daily.
  • If irritation occurs, a barrier cream may be used.

Flushing the Tube

The tube should be flushed with 20–30 ml of warm sterile water before and after each feeding.

The purpose of flushing is to prevent blockage and maintain tube patency.

Feeding Through the Tube

  • The patient should be in a semi-sitting position.
  • Feeding should be done slowly, by gravity or with a syringe.
  • After feeding, the tube should be flushed with 20–30 ml of water.
  • The patient should remain in the same position for 20–30 minutes after feeding.

Tube Replacement

In general, replacement is considered every 4–6 weeks, but the exact timing should be determined individually by the doctor.

Warning Signs — When to Call a Doctor or Specialist Immediately

Call a doctor, nurse, or specialist immediately if:

  • The tube moves out of place or comes out
  • The patient starts coughing or develops cyanosis
  • There is severe pain in the stomach or throat area
  • Feeding does not pass through the tube
  • There is pressure or resistance in the syringe
  • The tube appears blocked
  • Bloody or brownish content appears
  • The patient has severe nausea or vomiting
  • There is strong irritation of the nose or surrounding skin