Yes, ORS Can Be Administered Through Enteral Feeding
Yes, you can give ORS through enteral feeding tubes, and this is specifically recommended for patients who cannot tolerate oral intake but are not in shock. Continuous, slow nasogastric infusion of ORS via a feeding tube is particularly helpful for children who are vomiting 1.
When to Use Nasogastric ORS Administration
Nasogastric administration of ORS should be considered in the following situations:
- Infants, children, and adults with moderate dehydration who cannot tolerate oral intake 1
- Children with normal mental status who are too weak or refuse to drink adequately 1
- Patients with intractable vomiting - when small volumes administered every 1-2 minutes fail 1
- Infants unable to drink but not in shock - as an alternative to IV therapy when IV access is unavailable 1
Administration Protocol
The recommended rate for nasogastric ORS infusion is 15 mL/kg/hour 1. This continuous, slow infusion method allows for effective rehydration while minimizing vomiting 1.
For patients with moderate dehydration, the total volume should be 100 mL/kg administered over 2-4 hours 1. This can be delivered through the nasogastric tube at the steady rate noted above.
Important Contraindications
Do NOT use enteral feeding for ORS in these situations:
- Severe dehydration with shock or near-shock - these patients require immediate IV rehydration 1
- Altered mental status - risk of aspiration 1
- Intestinal ileus - oral fluids should not be given until bowel sounds are audible 1
- Anatomical abnormalities or gut malabsorption 2
Clinical Pearls
The key advantage of nasogastric ORS is that it allows you to continue oral rehydration therapy in patients who would otherwise require IV access 1. This is safer and more physiologic than IV fluids, avoiding risks of phlebitis and IV infiltrates 1.
Reassess hydration status after 3-4 hours of nasogastric ORS therapy 1. If the patient remains dehydrated, continue the infusion. Once rehydrated and able to tolerate oral intake, transition to oral ORS administration 1.
For patients in refugee or resource-limited settings where IV equipment is unavailable, nasogastric ORS can be life-saving even for infants in shock, though IV therapy remains the gold standard when available 1.