Feeding tube flushing is the routine practice of pushing water or saline through the tube to maintain its interior pathway. This action is a standard component of care, serving to prevent blockages that interrupt nutrition and medication delivery. Flushing works by clearing residual formula, crushed medication particles, and mucus that accumulate along the inside walls of the tube. Regular flushing is paramount for patient safety, ensuring the continued flow of necessary nourishment and hydration.
Preparation and Necessary Supplies
Gathering the necessary materials ensures a sterile and efficient process. A 60 mL syringe is typically used, often featuring a catheter tip or a specialized connection that securely interfaces with the feeding tube port. The size of the syringe is important because it allows for the administration of a sufficient volume of fluid without excessive force. The primary flushing solution is usually room-temperature water, although a healthcare provider may prescribe sterile saline in certain situations. For adult patients, the standard flush volume ranges from 30 to 60 milliliters (mL) of water per use. Always wash hands thoroughly or use an alcohol-based hand sanitizer before handling the tube system to minimize the risk of introducing bacteria.
Step-by-Step Flushing Procedure
Ensure the patient is positioned comfortably with their head elevated at least 30 to 45 degrees to prevent the risk of aspiration. Stop the feeding pump, if running, and clamp the tubing to prevent backflow while preparing the flush. Draw the prescribed volume of water into the 60 mL syringe, eliminating any air bubbles from the barrel. Connect the syringe securely to the feeding tube or extension set using the appropriate connection type.
Unclamp the tube and begin administering the flush water. The fluid should be introduced using a steady, gentle pressure on the syringe plunger, or by allowing it to flow by gravity if the plunger is removed. Avoid forcing the water against resistance, as high pressure can damage the tube or cause discomfort. Administering the water in a slow, pulsing motion can be more effective than a single sustained push, helping to dislodge minor residue. After the full volume has been instilled, clamp the tube before disconnecting the syringe, then promptly cap the tube port.
Determining Flushing Frequency
The timing and frequency of flushing depend directly on the type of feeding schedule and whether medications are being administered.
- For bolus (intermittent) feedings, a flush of 30 to 60 mL of water is performed immediately before and after each session to confirm the tube is clear and remove formula residue.
- For continuous feeding schedules, a routine flush of 30 to 60 mL is performed at least every four to eight hours to prevent the accumulation of formula and biofilm.
- Medication administration requires a flush both before and after giving the medicine to ensure the full dose is delivered and to clear the tube of drug particulates.
- If multiple medications are given sequentially, a small flush of 5 to 15 mL of water is recommended between each one to prevent potential drug interactions or clumping.
Troubleshooting Clogs and Obstructions
A feeding tube may occasionally become clogged, which is usually indicated by resistance when attempting to flush or administer a feed. First, check the tube externally for any obvious kinks or closed clamps that might be mimicking a blockage. If no external cause is found, a gentle attempt to clear the obstruction should be made using warm water.
Draw 30 to 60 mL of warm (not hot) water into a syringe, connect it to the tube, and use a slow, gentle push-and-pull motion to apply alternating pressure. This technique helps dissolve and dislodge solidified material without damaging the tube’s structure. If the clog does not clear immediately, leave the warm water soaking in the tube for 15 to 30 minutes to soften the obstruction before attempting the gentle push-and-pull motion again.
Never attempt to clear a blockage using excessive force, as this can rupture the tube or cause it to separate inside the patient. Furthermore, do not use sharp instruments, wires, or unprescribed household liquids like carbonated sodas or meat tenderizers. These methods are unsupported by evidence and can cause serious complications. If the clog cannot be cleared after two or three gentle attempts, or if any part of the tube appears damaged, contact a healthcare provider immediately for professional guidance or the use of specialized enzymatic declogging agents.