鼻饲

Nasal Feeding

高奶奶，左侧瘫痪，右侧卧位，呈嗜睡状态，吞咽困难，医嘱给予鼻饲，请照护人员通过鼻饲管为高奶奶进食。

Ms. Gao has suffered from paralysis on the left side and lied on the right side, showing a somnolent state, with dysphagia. She received nasal feeding according to the physician's advice. The caregiver was asked to feed the Ms. Gao through the nasal feeding tube.

步骤1：工作准备

Step 1: Preparation

1、环境准备：房间干净、整洁；空气清新、无异味

1. Preparation of environment: The room shall be clean and tidy; the air is fresh and free of peculiar smell

2、照护人员准备：着装整齐；七步洗手法洗净双手、戴☐罩。

2. Preparation of caregiver: The caregiver shall dress neatly, wash hands with the seven-step hand washing method and wear a mask.

3、老年人准备：照护人员站在床前，身体前倾，微笑面对老年人评估，核对；评估胃管插入长度完好；检查胃管固定周围的皮肤情况。

3. Preparation of the elderly: The caregiver stands in front of the bed, leans forward, and assess the elderly with a smile; assess the length of the gastric tube insertion is proper; check the skin around the gastric tube fixation.

4、物品准备：餐碗（内盛200升鼻饲液）、水杯（内盛温水）、推注器1个、弯盘2个、毛巾和餐巾纸、无菌纱布1块、胶布、软枕、别针、笔和记录单、免洗洗手液。

4. Preparation of articles: Bowl (containing 200 L of nasal feeding solution), water cup (containing warm water), 1 bolus injector, 2 bent plates, towels and napkins, 1 piece of sterile gauze, adhesive tape, soft pillow, pin, pen, record sheets and hand sanitizer.

步骤2：核对沟通

Step 2: Check and Communicate

5、治疗车推摆放在床头；核对老年人基本信息和饮食。

5. Place the treatment cart at the bedside; check the basic information and diet of the elderly.

6、附在老年人耳边唤醒老年人；做好解释，取得配合。摇高床头30度。

6. Awaken the elderly close to the ears of the elderly and explain to obtain cooperation. Rotate the bed head up to 30°.

步骤3：鼻饲前的准备

Step 3: Preparation before Nasal Feeding

7、再次洗手。在老年人的颔下垫毛巾，遮住老年人前胸，遮住右侧枕部，颌下放弯盘。

7. Wash hands again. Place a towel below the jaw of the elderly to cover the anterior chest and the right occipital region, and place a bent plate below the jaw.

8、戴手套。打开别针，打开胃管末端纱布；胃管末端放在颌下弯盘内，纱布放在治疗车污物碗内。

8. Wear gloves. Open the pin and open the gauze at the end of the gastric tube; place the end of the gastric tube in the submandibular bent plate, and the gauze in the dirt bowl of the treatment cart.

步骤4：检查胃管

Step 4: Check the Gastric Tube

9、用空推注器连接胃管末端，抽吸见胃液；将胃液推回；断开连接；推注器放在餐桌弯盘内；盖好胃管末端盖帽，放在颌下弯盘内。

9. Connect the end of the gastric tube with an empty bolus injector, with gastric juice observed after suction; push the gastric juice back and disconnect; place the bolus injector in the bent plate of the dining table; cover the end cap of the gastric tube and place it in the submandibular bent plate.

步骤5：进行鼻饲

Step 5: Perform Nasal Feeding

10、右手分别端起水杯、餐碗；用左手腕内侧测试水温、食物温度适宜；约38-40℃。

10. Hold up the cup and bowl with the right hand respectively; test the water and food temperature with the medial left wrist to be appropriate, about 38 - 40°C.

11、用推注器抽吸20 ml温水；注入胃管润滑胃管，断开连接，推注器放于治疗车弯盘内；盖好胃管末端盖帽。

11. Pump 20 mL of warm water with a bolus injector; inject it into the gastric tube to lubricate the gastric tube and disconnect; place the bolus injector in the bent plate of the treatment cart; cover the end cap of the gastric tube.

12、用推注器抽吸鼻饲饮食50毫升；打开盖帽，连接胃管；缓慢注入胃管，速度：10-13毫升/分。

12. Pump 50 mL of nasal feeding diet with a bolus injector, open the cap and connect the gastric tube; slowly inject it into the stomach tube at a rate of 10 - 13 mL/min.

13、注完后断开链接，盖好盖帽；持推注器王确；反复抽吸、推注、每次鼻饲量不超过200ml。

13. After injection, disconnect and cover the cap; hold the bolus injector properly; repeat pumping and injection, with the nasal feeding volume not exceeding 200 mL each time.

14、用推注器抽吸50ml温水，冲洗胃管管壁残渣；断开连接，将推注器放在治疗车上弯盘内；提起胃管，让胃管内水分充分流入胃内；冲洗胃管末端，差好盖帽。

14. Pump 50 mL of warm water with a bolus injector to flush the residues on the wall of the gastric tube; disconnect and place the bolus injector in the bent plate on the treatment cart; lift the gastric tube to allow the water in the gastric tube to fully flow into the stomach; flush the end of the gastric tube and cover it well.

15、用新的无菌纱布包好胃管末端，固定在老人头部上方。保持进食体位30分钟后再将床放平，避免误吸。

15. Wrap the end of the gastric tube with a new sterile gauze and fix it above the head of the elderly. Keep the patient in a feeding position for 30 min and then lay the bed flat to avoid aspiration.

步骤6：整理用物

Step 6: Sort Out the Articles

16、擦净口鼻分泌物，撤下毛巾；整理床单位；清洗推注器及餐具备用。洗手，记录。

16. Wipe off the oral and nasal secretions, remove the towel, make the bed, and clean the bolus injector and tableware for later use. Wash hands and record.

注意事项

Precautions

1、长期鼻饲老人应做好口腔清洁，避免口腔、气管、消化道感染；

1. The elderly with long-term nasal feeding shall be required to keep their mouths clean to avoid oral, tracheal and gastrointestinal infections;

2、老人鼻饲前后30分钟内禁忌吸痰

2. Sputum suction is prohibited for the elderly within 30 min before and after nasal feeding.

3、鼻饲老人用药须在医生指导下粉碎；

3. The drug for the elderly under nasal feeding must be crushed under the guidance of a physician;

4、鼻饲过程中，发现有恶心、呕吐，胃液中混有咖啡样物，立即停止操作并报告。

4. During nasal feeding, in case of nausea, vomiting and coffee-like substances mixed in the gastric juice, the operation shall be stopped immediately and report.