Gavage feeding is an artificial method of giing fluids and

SKILL 2: nutrients. This is a process of feeding with the tube

GASTRIC LAVAGE AND GAVAGE (Nasogastric Tube) inserted through the nose, pharynx, and
esophagus and into the stomach.
1. Informs patient of purpose of gavage or lavage. PURPOSE
 To provide adequate nourishment to patient who
GASTRIC LAVAGE
cannot feed themselves
 Gastric Lavage also commonly called stomach wash
 To administer medication
or gastric suction is the process of cleaning out the
 To provide nourishment to patients who cannot be
contents of the stomach. It has been used for
fed through the mouth. E.G. ; Surgery in Oral Cavity,
eliminating poisons from stomach.
unconscious or comatose state
INDICATION
INDICATION FOR ENTERAL TUBE FEEDING
1. With patient has ingested poison
2. Cleaning the stomach before and upper endoscopy
in someone who has been vomiting blood.
3. Collecting stomach acid for tests.
4. Relieving pressure in someone with a blockage in the
intestines.

CONTRAINDICATION
1. Loss of airway protective, such as in a patient with a
depressed state of consciousness.
2. Ingestion of a corrosive substance such as a strong
alkali
3. Ingestion of a hydrocarbon with high aspiration
potential
4. Patients who are at risk of haemorrhage or
gastrointestinal perforation.
2. Washes hands thoroughly.
To prevent microorganisms from inflicting into the health
GASTRIC GAVAGE / NGT FEEDING/ ENTERAL FEEDING
professional and the patient.

3. Gathers equipment at bedside:

A. Gastric Gavage: Measuring container with
correct amount of warm feeding solution,
bulb or asepto syringe (50 cc), a glass of
water (30-60 cc), stethoscope, drape or
towel, emesis / kidney basin and pulverized
medicines (if ordered) in separate measuring
cups to be dissolved in little amount of
water at the bedside.

Asepto syringe

B. Gastric Lavage: Clean gloves, asepto syringe

with a rubber bulb, normal saline
(temperature varies with the purpose of the
irrigation), measuring container, measuring
cup, stethoscope, emesis/kidney basin, drape
or towel.
 B. Aspirates for stomach contents by applying
negative pressure using the bulb or plunger
of the asepto syringe.
C. Re-pinches or clamps the tubing and measures
the amount of stomach contents.
D. Removes the bulb or the plunger, returns
aspirated stomach contents. Releases pinch
or clamp from the tubing to let aspirated
stomach contents to flow by gravity. If
more than half the last feeding or irrigation is
withdrawn or with coffee ground aspirate,
refer.

Before feeding the patient, always check for the

RESIDUAL, RR

4. Assists the patient to Fowler’s or sitting

position (if contraindicated, slightly elevates
patient to right side-lying position)

Gastric Gavage
9. Pinches proximal end of feeding tube and fills
syringe barrel, pour additional formula into
5. Places towel over the chest area. Has kidney syringe barrel when it is three quarters empty
basin at hand in case patient vomits. (If with feeding formula and let flow by gravity.
infant, provides a pacifier if available). Does not let the syringe barrel become empty
during feeding.
6. Pinches or clamps the tubing. Opens the free
end of the tubing.

7. Attaches the end of the asepto or bulb syringe

to the NGT tube.

8. Determines the patency and placement of the

NGT by:

A. Gently introduces a little air into the tube

using the bulb or asepto syringe and
auscultate for a gurgling sound with the
stethoscope on the epigastric area.
https://youtu.be/U_qzhQ4PJ-E
Bolus Feeding

https://youtu.be/hiSZntL8ubc

10. Adjusts the height of the syringe to desired flow

rate (12 – 18 inches from the insertion site). If
formula is thick or fails to flow, raises the
container a bit or applies slight pressure on the
plunger or bulb of the syringe.

GRAVITY FEEDING

11. Follows tube feeding with 30 cc of water to clear

the tubing.

FLEXITAINER 12. Gives pulverized medicines dissolved in little

amount of water separately and individually through
the tube before, during or after formula feeding
depending on the drug indication. Follows with few cc
of water to clear the tubing. Do not mix pulverized
medicines with feeding solutions

GASTRIC LAVAGE (FOLLOW STEPS 1 TO 8.)

13. Pinches proximal end of the tube and instills about

50 ml of normal saline solution (amount and
temperature vary upon doctor’s order) into the syringe
barrel
FLEXIPUMP
14. Pinches the proximal end of the tube when the  Vomiting, abdominal distension and pain;
barrel empties.  Perform a physical examination of the abdomen
including
 Assessment for presence of abdominal pain and
15. Connect the bulb or plunger of the syringe using bowel sounds
negative pressure to slowly aspirate the normal saline  Feeding should only be stopped abruptly for those
solution patients who demonstrate overt regurgitation or
aspiration.

‘’ Overt regurgitation refers to the voluntary or involuntary

16. Pinches the tube and removes the asepto syringe
movement of part or all of the stomach contents up the
from the tip of the tube then discards the aspirated
esophagus at least to the mouth, and often emerging from
content in the kidney basin or measuring container the mouth.
(checks to see that the amount drained,
equals/approximates amount instilled). 24. Monitor for breath sounds, bowel sounds,
gastric distention, diarrhea / constipation,
intake and output, daily weight and laboratory
17. Repeats inflow and outflow cycle until the return results. Check vital signs urine output, level of
flow appears clear. consciousness.
Bowel sounds: https://youtu.be/NqwTeM9h-Rc
18. Clamps end of tube. Removes the asepto or bulb
syringe

19. Closes and secures tubing. Removes towel and

kidney basin

20. Instructs client to remain in upright position for

30-60 minutes.

Post-Procedure
21. Washes, rinses and dries equipment & returns to
bedside.

22. Washes hands

23. Documents the following:

A. Gastric Gavage: type and amount of formula
given, time of feeding, amount and
characteristic of residual, client’s
tolerance/response to the feeding and
medications given.

Link: https://youtu.be/p8wJsBdNww4 - cghc

B. Gastric Lavage: type, color and consistency

of the drainedgastric contents, intake and output,
client’s tolerance/response to the procedure.

MANAGEMENT OF FEEDING INTOLERANCE

 When patient shows signs of feeding intolerance
such as nausea,
 Direction: Choose the best answer

1. Gastric Gavage is to ____1________ as

Gastric Lavage is to ____2________?

a. Perform bladder suction

b. Eliminate poisonous substance ingested by

the client

c. Provide nourishment to the client via NGT

The epiglottis is flap of cartilage located in the throat behind
the tongue and in front of the larynx. The epiglottis is usually d. NGT insertion
upright at rest allowing air to pass into the larynx and lungs.
When a person swallows, the epiglottis folds backward to
cover the entrance of the larynx so food and liquid do not
3. It is important to check the RR of the patient
enter the windpipe and lungs. After swallowing, the epiglottis prior to NGT feeding. This is done to prevent
returns to its original upright position. ______ in case the patient is tachypneic.
 Reduces heartburn. The theory that left-side sleeping
aids digestion and waste elimination was born a. Pneumonia
from Ayurvedic principles, but modern research also
supports this idea. A 2010 studyTrusted Source of 10 b. Infection
participants found a relationship between laying on the
right side and increased cases of heartburn (also
known as GERD) than when laying on the left c. Laryngospasm
side. Researchers theorize that if we lie on the left side,
the stomach and its gastric juices remain lower than d. Aspiration
the esophagus while we sleep.

4.There are several methods to check for the

patency of NGT. These are the following except?

a. X-ray

b. Percussion

c. Listen to the gurgling sound

d. Use of litmus paper

Litmus paper is either red or blue. The blue paper changes to
red, indicating acidity somewhere between the pH range of e. Aspirate for the gastric content
4.5 to 8.3. (Note that 8.3 is alkaline.) Red litmus paper can
indicate alkalinity with a change to blue. In general, litmus 5. During Gastric Lavage, after instilling the normal
paper is red below a pH of 4.5 and blue above a pH of 8.3.
saline, it is best to keep the bulb/ plunger of the
If the paper turns purple, this indicates the pH is near neutral. syringe at ______ pressure to be able to aspirate
Red paper that does not change color indicates the sample is
an acid. Blue paper that does not change color indicates the
for the gastric content.
sample is a base.
a. Positive
 b. Negative c. Neutral

c. Neutral d. Equal

d. Open 10. While an unchanged blue litmus paper means?

6. Below are the reasons why Gastric Gavage can a. Acid

be abruptly stopped, except?
b. Base
a. Signs of aspirations
c. Neutral
b, Coughing
d. Equal
c. Feeding Tolerance

d. Regurgitation

7. For Gravity feeding, what is the formula used to

determine for the gtts/min?

a. R = Volume / Time

b. R= Time/ Volume

c. R = Volume x Time

d. R= Time x Volume

8, If Mr. Pedro is given 333 cc of OF q 4 hrs and 30

cc of water for flushing what is the total intake for
24hrs?

a. 1, 998

b. 1, 452

c. 2, 178

d. 2,028

9. When using a litmus paper, an unchanged red

litmus paper signifies?

a. Acid

b. Base