Adults

Before the tube placement, you’ll be told what is going to happen, why, and what to expect. You will need to give verbal consent to have the tube placed.

It’s always good to have a loved one around before, during (when appropriate), and after the tube is placed, for moral support. If you are a caregiver of the person getting the tube and are allowed to be present for the placement and you know your loved one can be a little uncooperative, you might be called on to help comfort them while the tube is being placed. If you do not feel comfortable helping when called on (which is ok), you can voice this to the care team.

An NJ-tube can be placed in a variety of ways. You may be taken to a special procedure room in the Endoscopy or X-Ray department, or may be taken after the tube is placed to get an X-Ray, or you may not have to be taken to another room at all, based on the equipment available at the facility. When a special room isn’t needed, placement is done at the “bedside”.

It’s possible that the tube will be placed at the bedside using the CORTRAK* system. This device allows the staff to watch the tube’s passage on a screen. If used, a triangle-shaped sensor unit is placed on the lower chest area. If the facility you’re in does not have this device, staff may still place the tube at bedside, repositioning you as needed, during the procedure. The tube will pass through the nose and throat, into the oesophagus, down into the stomach and finally be guided through the small opening (called a pylorus) into the small intestine. Before the placement begins, the tube will be dipped in water or lubricating jelly to make it more comfortable to pass. The nurse may ask you or your loved one to tilt your head slightly forward, as this may help the tube pass more easily through the nose and throat. Gagging may occur, this can be uncomfortable to watch, but being there for your teen or loved one may provide them comfort and support and this part of the tube placement is very quickly over.

It may take a few minutes to get the tube in the best position for feeding .

Before use, the tube’s placement will be confirmed. If a stylet was used, it will be removed once the tube is in place and the tube will be secured to the cheek or nose or with another securing device.

It’s normal to have some gagging and discomfort at first. Positive thinking is very helpful during this stage. Remind yourself or your loved one often that many people have done this successfully and they can too. Good words of self-encouragement are: “I can do this! I am going to do this!”

It’s important to remember to brush your teeth or rinse your mouth several times a day to keep your mouth clean and moist. You’ll also want to ask if it’s OK to drink liquids, eat food or take oral medication with an NI-Tube.

Before you leave, make sure you have all the take-home supplies you need or know the plan on where to get them. Your care team will teach you how to give medications and flush the tube. It’s recommended to flush the tube every four hours during the day, before and after each feed or medication delivery to prevent clogging and keep the tube working. Your care team will also teach you how to connect the tube to the giving set and give the feed using a pump.

The first thing you’ll want to do when you get home is find a place to store supplies and to find a clean space for the tube feeds and pump.

Using a backpack to carry the pump and formula allows for more mobility, especially as you return to your normal routine. Gently loop the tubing and tape the loop to prevent accidental tripping over the tubing. If you have pets or younger children around, take steps to protect the tube feeds from them. Check the tube and make sure it remains securely taped.

Keep your urgent, emergent problems document handy in case you have questions.

Remember: the first day at home after any big change is going to require some adjustment. But before long, you’ll become more used to what to do and how to do it and you’ll develop a new routine that’s second nature to you.