Gastrointestinal Radiology > Procedures > Feeding Tube > Feeding Tube (2)


Feeding Tube Placement

Procedure

  1. With the patient supine, introduce an anesthetic gel (2% viscous Xylocaine) into the nostril to be intubated. Have the patient "sniff" the gel while the opposite nostril is occluded. It is also helpful to anesthetize the posterior pharynx with a topical spray, such as 10% lidocaine (Xylocaine).
     
  2. Before introducing the feeding tube into the patient, inject approximately 10 cc of water into its lumen to activate its Hydromer lubricant. Then, insert the stylet into the catheter to stiffen it. Bend the distal end of the stylet into a gentile curve to increase the torquability of the feeding tube. Before introducing the tube, stretch and bend its weighed end to make it more flexible and curved and, thus, easier to pass through the nose.
     
  3. Choose the most patent nostril for tube placement. With the patient's neck hyperextended, introduce the catheter tip gently into the nostril. Direct the catheter tip to the medial inferior wall of the nasal cavity. At no time should the catheter be forced against a resistance. If resistance is encountered, fluoroscopic guidance should be used to proceed further.

  1. When approximately 5 cm of the catheter have been inserted, have the patient flex his neck. Push the catheter gently while encouraging the patient to swallow. This will direct the catheter past the cricopharyngeus muscle and into the esophagus.
     
  2. Continue pushing the catheter until resistance is met. After the tip of the catheter enters the stomach, turn the patient into the right lateral or RAO position. Advance the catheter, and its tip should pass by gravity into the antrum of the stomach.

 


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