| Step |
Instructions |
| 1 |
Verbal consent for the procedure was obtained. Place the patient in a clinic procedure chair with the head in a flexed position. |
| 2 |
Deliver two puffs of Afrin and two puffs of 4% lidocaine to both nostrils. |
| 3 |
Select a small bore (10 French) silicone nasogastric feeding tube (Dobhoff) with an oral tip syringe. |
| 4 |
Take a measurement from the tip of the nose, around the ear, and down halfway between the xiphoid process and umbilicus. Use this measurement to determine the length of the tube needed to be advanced in order for correct placement. |
| 5 |
Lubricate the tip of the tube. |
| 6 |
Advance the tube through the right or left nare to the goal length previously measured in step 4. Encourage deep breathing techniques and small sips of water taken through a straw to assist the tube in correct placement. |
| 7 |
Before placement has been confirmed, a temporary tape is placed on the top of the nose at the half split length and wrapped around the tube. An additional piece is placed across the bridge of the nose. |
| 8 |
Confirm the correct placement of the tip of the feeding tube in the stomach with an X-ray of the kidney, ureter, and bladder. |
| 9 |
After placement has been confirmed, a permanent dressing is secured. The skin on the bridge of the nose is prepped with non-sting adhesive. A nasogastric tube holder adhesive is secured to the top of the nose pad. The two long pieces are wrapped around the Dobhoff for additional securement. A multi-purpose tube holder is placed on the patient's chest to further secure the lower portion of the tube. |
| 10 |
Feeding tube care and use are demonstrated by the dietician to the patient and caretaker. |
