The catheter is inserted into the stomach through the nose, filling liquid food, water and medicine from the tube method. Nasal feeding method is suitable for patients who can not eat by mouth, in the main acupuncture for patients with acute cerebral vascular disease, commonly used in the coma, the patient can not eat on their own pseudobulbar palsy caused dysphagia and esophageal cancer and other late. They can be from the stomach into the nutrient-rich flow of food to consume enough protein, water, drugs and a method of heat.
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Materials preparation: the therapeutic treatment of the disc into the bowl, spatula, tweezers, tube, sterile gloves, 50ml syringes, gauze, treatment towel, liquid paraffin, cotton swabs, tape, rubber band, stethoscope, warm, nasal food.Method EditorStep 1, cannula law
1) Gather the use of materials brought to the patient's bedside. Of conscious are good psychological care, clarifying the meaning and precautions treatment, performed spiritual comfort and encouragement, to eliminate the patient's nervous fears, so that patients can actively cooperates.
2) to assist the conscious patient supine, submandibular treatment shop towels, cleaning the nasal cavity.
3) wearing sterile gloves, lubricated with liquid paraffin gauze tube front of about 15-20cm, yarn Bhutto hand holding tube with one hand and forceps tube, along the side of the nose and gently inserted into the throat (about 14 -16cm at) patients may experience nausea reaction. Timely communication with the patient, guiding the patient swallow while the tube was slowly inserted. In case of cough, dyspnea, cyanosis, etc., represent strayed into the trachea, should immediately pull out, re-inserted after a short break. When you insert the tube can be withdrawn poor short and then move forward.
4) the length of the tube inserted in the "Basic Nursing Science" The measurement is from the patient's nose to the ear lobe and then to the xiphoid (or hairline to the xiphoid), adult about 45-55cm. In clinical applications that use this method when the catheter tube distal end or only reaches the gastric cardia gastric body, easy aspiration of gastric contents. Several clinical trials by using eyebrows - umbilical surface measurements, the tube can reach gastric body, antrum, which can effectively observe the stomach contents or enteral nutritional support.
5) coma patient swallowing reflex and cough reflex, not cooperation, in order to improve the success rate of intubation, clinical double pillow head rapid intubation, the patient is about two pillows at the head, making it as close to the mandibular sternal , post-nasal gastric tube into the hands quick intubation, the tube end along the rear wall of the esophagus to the stomach slide, this method can not be applied to unconscious collaborator, quickly and efficiently, reduce mucous membrane irritation of the throat.
6) When the catheter to a predetermined length, the available method or aspiration of gastric juice in the stomach with a stethoscope to listen to the sound of air over the water and other methods to determine the tube in the stomach.
7) fixed to the tube with tape and paste method to the nose or cheek. As patients nose sweating or oil secretion, patients stand activities and tape are likely to fall off, resulting in tube prolapse. My ward fixing method is to use two small wires through the tube, fastened to the patient's ear, the ear skin of patients after regular observation situation.Step 2, perfusion
1) before nasal feeding: patients with cerebrovascular accident coughing, swallowing reflexes and cardiac sphincter is open gastric reflux caused by aspiration is easy, and even pneumonia. Before feeding should head up 30-35 degrees, avoid eating during and after eating, choking, regurgitation, vomiting, etc., reduce the incidence of pneumonia.
2) nasal feeding method: Withdrawing have gastric observe whether or gastrointestinal bleeding gastric retention (such as bloody, brown juice or juice fasting more than 1000ml), you should stop feeding until the symptoms improved after the line feeding. Without exception slowly inject a small amount of warm water, then reperfusion nasal drug or liquid food. Drug pills should crush, dissolve poured. Feeding speed should be slow, and always observe the patient's response.
3) after nasal feeding: rinse with warm water 20ml tube, to avoid the food remaining in the stomach fermentation or deterioration, or clogging of the lumen causing gastroenteritis patients. The tube end cap is fixed, and wrapped with gauze, rubber band fastened with safety pins fixed to the side pillow. Holding semi-recumbent position for 30-60 minutes and then resume the supine position.
4) finishing bed unit, was used to clean the syringe into the post-treatment wash bowl, cover gauze spare.
5) under doctor's orders recorded patient response and nasal volume.Step 3 extubation law
For long-term patients stop or nasogastric feeding tube needs to be replaced.
1) Prepare a bowl of dressing to the patient bed, good psychological care of patients, in order to get fit.
2) the curved plate placed in the patient jaw, thrown off the fixture.
3) wearing sterile gloves, wrapped with gauze tube nostril, guiding patients to do deep breathing, gently extubation time to complete action to be slowly exhale, wrapped in gauze tube placed in a curved plate. Coma patient extubation throat to the stomach quickly pulled back off to avoid liquid drip into the trachea.
4) Clean the patients mouth and nose, face, wipe the tape marks, to help patients gargle, get comfortable lying position, finishing bed unit, was used to clean up.
5) timely recording nursing records extubation time and patient response.
6) As for the replacement of the patient's stomach, the tube should be pulled out after the last feeding at night, the next morning before the feeding tube from the other nostril.
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