What Is the OG Tube Feeding Procedure?
The OG (orogastric) tube feeding procedure is a common method used for delivering nutrition and medication directly into the stomach. It involves the insertion of a tube through the mouth, down the esophagus, and into the stomach. This procedure is typically carried out by a healthcare provider, such as a nurse or doctor, and is used in a variety of clinical settings.
The OG tube is specifically designed for gastric feeding. It is different from other types of tubes, such as nasogastric tubes (NG) or endotracheal tubes, which are used for different purposes. The OG tube is inserted through the mouth, while the NG tube is inserted through the nose, and the endotracheal tube is used to secure the airway.
The OG Tube Feeding Procedure
The OG tube insertion procedure begins with the patient being positioned in a comfortable and upright position. The healthcare provider will insert a lubricated tube through the patient’s mouth and guide it down the esophagus into the stomach.
The correct placement of the tube is confirmed by measuring the length of the tube inserted, confirming placement via x-ray, using the auscultation method, or checking the pH of gastric contents obtained (the safest and most accurate method).
When performing an OG tube feeding procedure, healthcare providers must gather the necessary materials to ensure a smooth and efficient process. Materials needed for OG tube feeding include:
- OG tube
- Tape or tube holder
- pH indicator strips
It’s important for healthcare providers to gather and prepare these materials before starting the OG tube feeding procedure to ensure the patient’s safety and comfort.
The patient’s position plays a significant role in the success of the OG tube insertion. Typically, the patient is positioned in an upright or semi-upright position, as this allows gravity to assist in the passage of the tube into the stomach. The patient’s head should be raised to approximately 30 to 45 degrees to facilitate a more straightforward insertion. The use of a pillow or neck support can help maintain this position and increase patient comfort.
Before initiating the tube insertion, the healthcare provider should verify the correct length of the tube required for the specific patient. This measurement is typically determined by measuring the distance from the patient’s nose to the earlobe and then to the midpoint between the xiphoid process and the umbilicus. Ensuring the accurate length of the tube prevents complications, such as aspiration pneumonia or incorrect placement.
Once the tube length is confirmed, it is time to insert the tube through the patient’s mouth. Lubricating the tube with a water-soluble lubricant helps reduce any discomfort or irritation during insertion.
The patient is encouraged to swallow in a cooperative manner. This swallowing action helps facilitate the passage of the tube through the esophagus and into the stomach. It is important to proceed slowly and gently to minimize the risk of complications or patient discomfort.
Once the tube is successfully inserted into the stomach, it is important to confirm its correct placement. The safest way is to test the pH of the gastric aspirate obtained from the tube. A pH level between 1 and 5 indicates gastric contents, confirming proper placement.
Secure the Tube
After confirming the correct placement of the tube, it is secured in place using tape or a tube holder. The healthcare provider carefully tapes the tube to the patient’s face to prevent accidental removal or displacement. It is crucial to ensure that the tape is not too tight, as it can cause discomfort or pressure on the patient’s skin.
Connect the Feeding System
To begin the process, health care providers should first wash their hands thoroughly and put on gloves to maintain a sterile environment. They should also ensure that the patient is in a comfortable position, ideally sitting upright or at a slight angle to facilitate the flow of nutrition.
Next, the feeding tube connector should be checked for proper alignment and cleanliness. The connector is designed to securely attach the feeding tube to the feeding bag or syringe, so it is crucial to inspect it for any damage or blockages. If using a pre-packaged feeding bag, ensure the connector is properly sealed and sterile.
Once the connector is ready, it can be attached to the feeding tube. Care should be taken to match the appropriate connectors, ensuring a secure and leak-proof fit. The connection should be made gently but securely, avoiding excessive force that could damage the tube or compromise the integrity of the system.
Once the feeding system is properly connected, healthcare providers should double-check the integrity of the entire system. This includes inspecting the tube, connectors, and bag or syringe to ensure everything is securely in place. It is also essential to verify that the flow control mechanism, such as a clamp or pump, is functioning correctly before starting the feeding process.
Risks Associated with OG Tube Feedings
Orogastric tube feedings are commonly used to provide nutrition to patients who are unable to eat or drink orally. While this procedure can be beneficial for patients requiring enteral nutrition, there are potential risks and complications that healthcare providers and patients should be aware of.
One of the major risks associated with OG tube feeding is the potential for aspiration. If the tube is not properly placed, there is a risk that the gastric contents could enter the lungs instead of the stomach, leading to aspiration pneumonia. To minimize this risk, healthcare providers are trained to ensure correct placement and take proper precautions.
OG tubes can sometimes cause blockages in the gastrointestinal tract, especially if the tube becomes dislodged or if there are pre-existing conditions such as bowel strictures or obstructions. Bowel obstructions can be painful and may require additional interventions such as surgery to resolve.
Improper or incorrect placement of the OG tube can lead to complications. The tube must be inserted correctly, with the tip of the tube positioned in the stomach and not the esophagus or lungs. Incorrect placement can result in issues such as esophageal varices, esophageal strictures, or damage to surrounding tissues. Healthcare providers must carefully assess the patient’s anatomy and use appropriate techniques to ensure accurate tube placement.
While the “whoosh test” is commonly used as a quick bedside method to confirm OG tube placement, it has limitations. Sometimes, the test may give a false positive, leading to incorrect tube placement. This can occur if the tube is inadvertently inserted into the lungs rather than the stomach. The “whoosh test” relies on the assumption that the air will enter the stomach and produce the characteristic sound and sensation. However, in cases of misplaced tubes, air may still be aspirated, leading to a false confirmation.
Risk of Infection
The insertion site for the tube is susceptible to microbial contamination, and diligent hygiene measures must be practiced during the tube insertion and maintenance process. Regular cleaning of the insertion site, using sterile techniques during tube feeding administration, and proper care of the tube are essential to prevent infection.
How RightBio Metrics Can Help
RightBio Metrics utilizes pH testing to confirm the correct placement of the feeding tube. The pH testing involves assessing the acidity of the gastric contents obtained through the tube. By analyzing the pH level, healthcare providers can determine if the tube is positioned correctly within the stomach or if it has been inadvertently placed in the lungs or esophagus.
Having an accurate and reliable method to confirm tube placement is essential for the safety and well-being of patients. By using RightBio Metrics’ pH testing, healthcare providers can reduce the risk of aspiration and ensure that enteral nutrition is being delivered directly and safely into the gastrointestinal tract.