Pediatric nasojejunal feeding tube placement

  • Patient preparation: anesthetize the nostril with viscous lidocaine
  • Contrast used: high osmolar water soluble
  • Technique:
    — Use 6 French or 8 French or 10 French feeding tube depending on patient age
    — Flush tube with water, place tube in warm water for a few minutes
    — In supine position, place tube through nose to stomach
    — In right posterior oblique position advance tube to antrum
    — In left posterior oblique position advance tube through pylorus to duodenal bulb
    — In supine position advance tube through the C-loop
    — In right posterior oblique position advance tube past the Ligament of Treitz
  • Images to obtain: at end of exam AP image of the abdomen after injecting 10 cc of contrast to document tube tip position in the jejunum
  • Looking for: tip of nasojejunal tube tip at or beyond the duodenal-jejunal junction
  • Post procedure tasks: flush tube with sterile saline, have the clinical service secure the tube in place with a transparent dressing or a bridle