A nasogastric (NG) tube is a flexible, small-bore tube inserted through the nose, down the esophagus, and into the stomach. This device delivers nutrition, fluids, and medications, or decompresses the stomach by removing air and fluid. A common complication is an unexpected tube blockage. Safely resolving this occlusion ensures continuous care and prevents tube replacement.
Recognizing the Signs of a Blockage
The first indication of a blockage is often a noticeable resistance when attempting to flush the tube with water. You may find it impossible to push formula or medication through the tube using a syringe. If a feeding pump is in use, it will frequently alarm, signaling a high-pressure occlusion within the line.
Before assuming a clog, visually inspect the external tubing for any obvious kinks or tight bends. Adjusting the patient’s position or straightening a looped segment may restore the flow. If the tube appears clear externally and resistance remains, a material blockage is the likely cause.
Safe Techniques for Clearing the Tube
When encountering resistance, stop all current feeding or medication administration to prevent applying excessive pressure. Attach a 30-milliliter or larger syringe to the feeding port; smaller syringes can generate too much pressure and damage the tube. Gently attempt to aspirate, or pull back on the syringe plunger, to see if the blockage can be withdrawn.
If aspiration is unsuccessful, the primary method is to use warm water. Draw 15 to 30 milliliters of warm water into the syringe and attach it to the tube. Use a gentle push-pull motion, applying slow, steady pressure to push the water in and then pulling back to dislodge the material. Repeat this technique for several minutes without using forceful pressure.
If the clog persists, clamp the tube and allow the warm water to soak against the obstruction for 15 to 20 minutes. This soaking period can help soften dried formula or medication residue that is causing the occlusion. After soaking, repeat the gentle push-pull technique to try and clear the tube. For difficult clogs, commercially available enzymatic declogging agents, such as Clog Zapper, or a mixture of pancreatic enzymes and sodium bicarbonate may be recommended by a healthcare provider.
Important Safety Precautions
Never use excessive or forceful pressure on the syringe plunger. Too much force can cause the tube to rupture or become displaced, posing a serious risk. Avoid using household liquids like cranberry juice, meat tenderizer, or cola, as these solutions are not proven effective and may cause the clog to harden or damage the tube material.
Never attempt to use a wire, scissors, or any sharp object to manually clear the tube lumen. If gentle attempts with warm water are unsuccessful after two or three cycles of the push-pull and soak method, stop immediately. Contact a medical professional, such as a doctor, nurse, or home health agency, for further instructions. Professional guidance is also required if the patient experiences pain, coughing, or difficulty breathing, as this may signal tube displacement.
Preventing Future Clogs
The most effective strategy for managing an NG tube is prevention. A consistent flushing protocol with water is the most important preventative measure. Flush the tube with at least 30 milliliters of water before and after every use, including before and after each feeding and medication administration.
For patients receiving continuous feeds, the tube should be routinely flushed with 30 milliliters of water every four to eight hours. When administering medications, use liquid formulations whenever possible, and if tablets must be crushed, ensure they are ground to a fine powder and dissolved completely in water before administration. Administering medications separately, with a water flush between each one, also helps prevent them from interacting and creating a solid mass.