Gavage, or tube feeding, is used to provide nourishment to a patient who is unconscious, unable to swallow, or too weak to eat.

A liquid formula is ordered by the physician and provided by food service. Formula provided by food service must be marked with the patient’s name and the date prepared. A nasogastric tube or a small caliber feeding tube must be in place for feedings. Local Department of Nursing procedure will specify the frequency with which the tube must be changed when the patient is receiving gavage feeding for a prolonged period of time.

a. Equipment. 

(1) Syringe.

(2) Liquid feeding of type and amount prescribed.

(3) Feeding set (bag or bottle).

(4) Cup of water.

(5) Chux pad.

b. Procedure. 

(1) Assemble the necessary equipment and prepare the feeding by pouring the prescribed amount into the feeding set. Do this in a clean work area, never in the dirty utility room.

(2) If permissible, position the patient in an upright sitting position or modified Fowler’s position.

(3) If clamped, unclamp the nasogastric tube and check the tube for placement. Attach the syringe and aspirate gently to ensure that the tube is in the stomach. Reclamp the nasogastric tube.

(4) Suspend the filled feeding set from an IV pole or irrigating stand. Unclamp the tubing and allow the feeding to advance to the end of the tubing, expelling all air. Attach the adapter at the end of the tubing to the nasogastric tube. Place a chux pad under this connection.

(5) Adjust the flow rate to deliver the required number of ml per minute. This can be done by adjusting the clamp located below the drip chamber. If precise control of feeding is required, the feeding may be controlled by use of an infusion pump such as IMED or IVAC. If pump control is not used, the patient must be observed at frequent intervals during feeding to prevent the feeding from being administered too quickly.

(6) When the required feeding has been administered, clamp the feeding tube and disconnect it from the nasogastric tube.

(7) Clear the nasogastric tube of feeding residue by instilling 30-50 ml of plain water. Clamp the tube.

(8) Record the type and amount of feeding, along with the amount of water given, on the I&O worksheet.

(9) Record the procedure and the patient’s tolerance in the nursing notes.

(10) Dispose of used equipment properly. Local Department of Nursing policy will specify the length of time a feeding set may be used before being exchanged.