What Are the Steps of Orogastric Tube Feeding?

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When someone loses the ability to eat and drink normally, it’s vital that they find another means to intake their fluids and nutrients. One of the most reliable ways to resolve that dilemma is to use an orogastric (OG) feeding tube. But while OG tubes are reliable, they are only effective upon proper placement and use. That’s why we have detailed the steps of orogastric tube feeding in the article below.

Determining that an OG Tube is Necessary

Before considering proper OG tube placement, you and your healthcare provider must reach the conclusion that an OG tube is necessary in the first place. OG tubes Become useful in any scenario in which someone else loses the ability to eat or drink, whether due to an injury or some other condition.

In those situations, an OG tube gives a person the ability to ingest the liquids and nutrients that are essential to their bodily functions and survival since doing so naturally is no longer a viable option. OG tubes are also useful for administering medication, and people of all ages may need an OG tube at some point in their life.

As such, it is difficult to deny the usefulness of OG tubes. However, these feeding tubes are only effective if the person placing them knows how to do so correctly, which the next section will cover.

Placing the OG Tube

Correct placement from the start is crucial to the success of an OG tube. Additionally, improper placement can lead to several complications, all of which are both adverse and avoidable. To aid in the prevention of those complications, we have provided a brief outline of the steps you should follow during OG tube placement.

OG Tube Placement Preparation

Preparation is key to your OG tube placement process, and this step involves two main objectives—to collect the items you will need during the rest of the process and to ensure that those items and the environment in which you perform the placement are as clean as possible.

Begin by gathering all of the items and tools that are necessary for OG tube placement. The list below provides one example of the collection of items you may need to complete this process:

  • OG tube
  • Measuring tape
  • Pen/marker
  • Tape
  • Lubricant
  • PH testing kit
  • Gloves

After you collect the OG tube placement equipment and tools that you need, it is important to ensure they are sterile as well. You should also wash your hands thoroughly and put on gloves before you perform the placement.

Lastly, you should make sure that you are comfortable performing OG tube placement if you are the one tasked with doing so. When in doubt, you should seek the guidance of a medical professional if you are not confident in your placement skills.

OG Tube Measurements

Taking accurate measurements before placing an OG tube is very important. Measuring allows you to make sure that the OG tube will reach the correct depth within the person’s digestive system. But if you get the measurement wrong, you may run into some complications that require you to restart the placement process.

In other words, measuring the OG tube properly is the first opportunity to avoid a common placement pitfall. Fortunately, there is an easy way to take an accurate OG tube measurement.

Begin by measuring or estimating the distance from the person’s lips to the back of their throat. After recording that number, measure the distance from the back of the throat to the stomach. Once you have those two measurements, add them together to find the length of the tube that you’ll need to mark.

Use your tape measure to mark the total distance with a marker or pen directly on the OG tube. Ensure that the mark is clear, as you’ll need to refer to it in the next step.

Inserting the OG Tube

Now that you have a clear measurement to work with, it is time to insert the OG tube into the person’s mouth. However, before you begin, you should apply lubricant to the tip of the OG tube, as this will help it insert more effortlessly into the person’s oral cavity.

Begin inserting the tube while preparing to angle the tube down the person’s throat rather than upwards. Once you sense that the tube has reached the back of the person’s mouth, instruct them to flex their neck and begin swallowing. This action should allow the tube to pass through the esophagus rather than the trachea.

As you insert the OG tube through the esophagus, you can expect to meet mild resistance. However, strong resistance may indicate that the tube has curled and may need to be reinserted.

Continue inserting the tube until the mark you made earlier reaches the outside of the person’s lips. At that point, you can secure the tube in place with tape. Throughout the entire placement process, be sure to monitor the person receiving the tube for any signs of complications, discomfort, or distress.

Testing Placement

After you have inserted the tube, it is time to test the placement. Since OG tube misplacements are all too common, and misplacements can lead to negative complications, testing placement before performing any feedings is incredibly important.

There will be obvious signs of misplacement that you will likely notice immediately. For instance, if the person begins choking, gagging, vomiting, or changing colors, chances are you have misplaced the OG tube.

One of the more refined ways to test OG tube placement is with an X-ray machine. However, as an alternative, you can also confirm OG tube placement by using a PH test.

PH tests have a few advantages over X-rays that will make testing more convenient for you. First, they provide results almost immediately. They also do not require the person to undergo radiation, and they tend to be more cost-effective as well. But regardless of the means you use to test placement, the most important guideline is to ensure that you do so in some way before feeding.

OG Tube Feeding Period

Once you have inserted the OG tube and confirmed that you have placed it correctly, you can proceed to the feeding period, which is the step during which the tube will serve its primary function. During the feeding period, the OG tube will become the manner in which the person ingests their food, water, and any medications that they require.

However, although feeding may seem like a straightforward phase of OG tube use, you’ll need to perform feedings with care and caution. It’s typically best to continue performing PH tests before each feeding to guarantee that the OG tube is still at a proper depth.

Generally, OG tubes are intended for relatively short feeding periods that last for about 4 to 6 weeks. After those weeks have elapsed, the next step of the OG tube feeding process will commence.

OG Tube Removal or Replacement

The last step in OG tube feeding is removal or replacement. In the best case scenario, the person using the OG tube will have the opportunity to return to normal eating and drinking after their OG tube feeding period. Unfortunately, that is not always the case.

After 4 to 6 weeks of feeding, some people will continue to require some form of a feeding tube. At this stage, it will become necessary to either replace the original OG tube with another one or replace it with a feeding tube that is meant for long-term use.

Alternatives to OG Tubes

Using an OG tube is not the only alternative to the traditional means of eating and drinking. For instance, a nasogastric (NG) tube is one of the most common alternatives to an OG tube. NG and OG tubes are similar in many ways, but they have some key differences. The main difference is that an NG tube enters the person’s body through the nose, while an OG tube enters the body through the mouth, as we described above.

Both NG and OG tubes are great for short-term feeding periods, but they are not the only feeding option for shorter periods. In place of an NG or OG tube, an intravenous feeding method can be reliable as well. This option is especially helpful if NG or OG placement is difficult for some reason or the person’s digestive system is not functioning in some way other than being unable to swallow.

As we just mentioned, these feeding methods are perfect for a period of a few weeks, but there are also feeding methods that are better for longer time spans. For longer feeding periods, a gastric tube or a jejunostomy tube are better options.

Still, no matter what kind of feeding tube you need to use, it is important to learn about how to use one properly before you begin receiving or performing feedings. By following the steps for OG tube feeding that we described above, you’ll be well on your way to ensuring safe use.

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