Administering a medicine through an enteral feeding tube

Considerations

Before administering medication via an enteral feeding tube, it is important to consider the type of water and syringe used.  

Using the appropriate water ensures patient safety and reduces the risk of infection or tube blockage.  

Selecting the correct syringe size helps maintain accurate dosing and safe delivery. 

These factors are essential for effective and safe medication administration. 

Water 

Use the appropriate type of water for preparing the medicine and flushing the tube.

This will be based on local water supply, tube exit site and your local enteral feeding policy.

Tubes terminating in the stomach

Use freshly drawn tap water or sterile water 

Tubes terminating in the jejunum

Use boiled and cooled water, or sterile water such as water for irrigation 

Immunosuppressed patients

Use boiled and cooled water, or sterile water such as water for irrigation 

Syringe

Type

Use EnFit® (ISO 80369-3) syringes for flushing and medicine administration.

For immunocompromised people and enteral feeding tubes that terminate in the jejunum, single‑use sterile syringes are recommended.

Use of reusable syringes should follow an individual risk assessment based on the degree of immunosuppression and the specific clinical risks. For example, in a mildly immunocompromised person with a gastric tube and no acid‑suppressing therapy, syringe re‑use may be considered appropriate.

Size

Select a syringe size that can accurately measure the required volume for medicines and flushes. Smaller sizes may be required for children due to smaller doses.

The largest functional syringe size should be used, as small syringes create high intraluminal pressures and may damage the tube. 

Dead-space volume

Enteral syringes have a substantial dead-space at the tip. 

Filling this space would pose a risk of medicine overdose, leakage, wastage and contamination of the area.  

Always use the appropriate bottle adapters to prevent dead-space from filling. These are available from the enteral syringe manufacturers.  

Step by step guide

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