From the Guidelines
Nurses should flush a nasogastric (NG) tube with at least 30 mL of water before and after medication administration or feedings, and at least every 4-6 hours for continuous feedings, as recommended by the most recent guidelines 1. To properly flush a nasogastric (NG) tube, nurses should first verify tube placement, then use a 30-60 mL syringe filled with 30 mL of water (room temperature or warm) and gently flush the tube. Before flushing, check for residual gastric contents by aspirating with the syringe, documenting the amount, and returning it to the stomach unless contraindicated. When flushing, maintain steady gentle pressure on the syringe to prevent tube occlusion. For medication administration, flush with 15-30 mL of water before and after each medication, waiting 5-10 minutes between different medications. If the tube becomes clogged, try using warm water or carbonated beverages like cola (30 mL), or consult pharmacy for appropriate declogging solutions. Never use excessive force when flushing as this could rupture the tube or cause patient discomfort. Regular flushing prevents tube blockage by removing medication residue and feeding formula that could otherwise harden inside the tube, ensuring proper medication delivery and feeding administration while maintaining tube patency, as supported by recent studies 1. Key points to consider when flushing an NG tube include:
- Using at least 30 mL of water for irrigation when giving medicines or when flushing small diameter nasogastric tubes may reduce the number of tube occlusions 1
- Adequate flushing of the tube between feed and/or medications is necessary to prevent drug-drug interactions and tube occlusions 1
- Nurses should be aware of the importance of proper NG tube flushing and follow established guidelines to ensure patient safety and prevent complications 1.
From the Research
NG Tube Flush Directions for Nurses
To ensure proper care and maintenance of nasogastric (NG) tubes, nurses must follow specific guidelines for flushing these tubes. The following points outline the key considerations:
- Frequency and Volume of Flushing: According to 2, the tube should be flushed with at least 30 ml of water before and after administration of medications. Additionally, 3 states that 94% of nurses regularly flush the enteral tube before each feeding, after each feeding, and every 4 hours.
- Importance of Flushing: Flushing the NG tube is crucial to prevent clogging and ensure the proper administration of medications and feedings. As noted in 4, nearly all nurses (96%) reported flushing a tube after giving medication.
- Methods of Flushing: The types of irrigants used for flushing include tap water, sterile water, and sterile normal saline solution, as mentioned in 3.
- Administration of Medications: When administering medications via an NG tube, it is essential to flush the tube with water before and after giving medicines, as reported in 2 and 4. If multiple medicines are given, flushing the tube between each medication is also recommended.
- Best Practices: Nurses should be equipped with the relevant knowledge to flush a nasogastric tube before the administration of feed or medication, as emphasized in 5. Regular flushing and proper care of the NG tube can help prevent complications and ensure patient safety.
Some key points to consider when flushing an NG tube include:
- Using at least 30 ml of water for flushing
- Flushing before and after medication administration
- Flushing every 4 hours
- Using appropriate irrigants, such as tap water or sterile water
- Administering medications separately and flushing between each dose
- Regularly checking the tube for clogs and flushing as needed