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Mic Gastrostomy Feeding Tubes Care Booklet.Pdf GASTROSTOMY CARE GUIDE GASTROSTOMY CARE GUIDE Universal INDICATIONS FOR Adapter TUBE FEEDING Medication PATIENT INFORMATION Complete nutrition supports Port development, growth, and heal- ing. If the ability to eat or Replaceable Date of tube insertion swallow is lost, or the patient is unable to tolerate food, enteral Feeding feeding can sustain life, nour- Patient name Phone ish, and even increase body Adapter weight. Tube feeding is also Physician Phone used to supplement a deficient food and fluid intake. The feed- Type 0100 0110 0150 0160 (circle one) Fr Size ing procedure can be managed safely and economically at Manufacturer's lot number (printed on package) home, away from the hospital setting. A surgical gastrostomy Mark above the SECUR-LOK® Ring in cm provides access to the stomach if long term nutritional support (this means the mark after the initial placement) is necessary. Balloon volume if 0100, or 0110 type G Tube Pure medical grade silicone (the volume should be between 7 and 10 cc) construction makes MIC Feeding Tubes durable, yet soft and comfortable to wear. They SECUR-LOK® Formula are also translucent, allowing Ring visualization of the inside of Brand name the tube above the skin line. All MIC Enteral Feeding Tubes Method of delivery are latex free. Volume, rate and time the feeding should take MIC PEG Total amount of daily water PEG stands for Percutan- eous (through the skin) Additional ingredients Endoscopic (use of a flexible lighted tube to visualize tube Irrigate the tube with water before and after feeding and medication placement) Gastrostomy administration. (surgical opening into the stomach). PEG Tubes (0150 Internal and 0160 series) and Retention Checking Residual Gastrostomy Tubes (0100 and 0110 series) are the same in Fig.1 Dome Check residual before feeding. Notify physician if residual is more than cc function. PEGs have internal retention domes; G Tubes have retention balloons. PEGs have MIC PEG TUBE replaceable feed ports; G Tubes Series 0150 & 0160 do not because the feed port houses the balloon inflation valve. internal retention dome pre- vents accidental removal of the As the physician inserts the PEG assuring that the tract PEG Tube, a dilator tip on the forms correctly. The PEG Tube tube itself helps to create a must be removed by a physi- stoma the size of the PEG cian once the tract is healed. A Tube. Gradually, the stoma balloon G-Tube that can be heals around the tube forming safely and easily changed at a sealed tract. The home may replace it. 18 3 GASTROSTOMY CARE GUIDE GASTROSTOMY CARE GUIDE CAUTION DO NOT ATTEMPT TO REMOVE A PEG. NOTES: SERIOUS COMPLICATIONS CAN RESULT. PEG TUBES MUST BE REMOVED BY A PHYSICIAN OR CLINICAL SPECIALIST. If the PEG SECUR-LOK® Ring is sutured to the skin, care for the stoma is as follows: (Fig. 2) 1. Wash hands thoroughly with soap and water. 2. Saturate a cotton-tipped applicator with a 1/2 strength solution of hydrogen peroxide and sterile water. 3. Gently soften and remove any crusts Cleansing from around and a new underneath the disc. gastrostomy site 4. Finish with a clean, dry applicator. Do not touch the area with your hands. After the sutures are removed, follow the routine tube Fig. 2 care instructions on page 6 of this booklet. PEG FEEDING ADAPTERS To replace an adapter, remove existing adapter from the PEG Tube. Trim stretched or torn tubing with scissors, then reconnect the new adapter. ADAPTER SIZES Universal (Universal) Feeding 0135-14 fits 14 Fr PEG Adapter 0135-20 fits 20 Fr PEG 0135-24 fits 24 Fr PEG (Bolus) 0136-14 fits 14 Fr PEG 0136-20 fits 20 Fr PEG 0136-24 fits 24 Fr PEG Bolus Bolus adapters are useful for Adapter drainage and/or stomach decompression because they do not have universal connectors inside the feed ports. 4 17 GASTROSTOMY CARE GUIDE GASTROSTOMY CARE GUIDE MIC GASTROSTOMY TUBE GLOSSARY OF TERMS Feed Port FEEDING PORT MIC series 0100 tubes have a ASPIRATION: Accidently inhaling liquid into the windpipe and/or lungs. "universal connector" inside Balloon Port the feed port to prevent the BOLUS FEEDING: Large amounts of formula delivered through the tube. port from leaking after repeat- Medication ed use. (Fig. 3) If your formula Port CONSTIPATION: Bowel movements (stools) sometimes painful, and difficult to pass. delivery set does not fit the connector, use a MIC 0105-6 CONTINUOUS FEEDING: Formula delivered at a constant rate throughout the day (or night) extension set to connect the without interruption. tubes. MIC Bolus Gastrostomy Tubes, series 0110, have no Universal DIARRHEA: Frequent, loose, or watery bowel movements. universal connectors or med- Connector ication ports. To drain or ESOPHAGUS: The passage in the throat through which food passes from the mouth into decompress the stomach, use a the stomach. Bolus Gastrostomy Tube. The Bolus Port accepts most con- FEEDING PUMP: A small machine, plug-in or battery powered, that automatically controls nectors. If additional tubing length is needed, MIC 0105 the amount of formula being delivered through the feeding tube. extension sets may be pur- FEEDING SET: Tubing that connects the feeding container to the feeding tube. chased from your medical sup- Centimeter plier or from Ballard Medical Products Customer Service. Markings FEEDING TUBE: Tube through which formula flows into the stomach or intestine. (gastrostomy or jejunostomy tube) MEDICATION PORT The medication port accepts G TUBE: Gastrostomy tube. A tube that passes through the skin into the stomach. Also the Luer connectors on most syringes. The port joins the ® called feeding tube. main tube lumen, there is no SECUR-LOK separate channel. Before and Ring GASTROESOPHAGEAL REFLUX: Backing up of formula or gastric fluid from the stomach after giving medication, stop into the esophagus. the formula and flush water through the medication port to GASTRIC DECOMPRESSION: The removal of gas or fluid from the stomach. clear the tube. If your feeding (Also called "venting") set connector fits into the med- ication port, you may also use Internal GASTROSTOMY: A surgical opening (stoma) through the skin into the stomach. the port to give formula. Retention SECUR-LOK® RING Balloon GRANULATION TISSUE: Fleshy projections on the surface of the stoma that form If both the tube and the ring fibrous scar tissue. are dry, friction holds them together preventing the tube GRAVITY DRIP: Formula flows into the feeding set by gravity. from sliding inside the stom- ach. Position the ring 3 mm Tip INTERMITTENT FEEDING: Small amount of formula given frequently. (the thickness of a dime) above Fig. 3 the skin.(Fig. 4) IF THE NUTRIENTS: Food or any substance that nourishes the body-protein, carbohydrate, fat, RING POSITION IS TOO vitamins, minerals, and water. CLOSE FOR VERY LONG, A PRESSURE INJURY MIC SERIES 0100 G TUBE STOMA: Surgical opening into the body. COULD RESULT. BALLOON PORT STOMACH RESIDUAL: Stomach contents 4 hours after feeding. This port houses the balloon valve. DO NOT INADVER- SYMMETRICAL: Correspondence in shape, size, and relative position of parts on opposite sides. TENTLY GIVE MEDICA- TION OR FORMULA INTO THE PORT. If this happens, the valve may clog and the gas- Fig. 4 trostomy tube will be more dif- ficult to remove from the stom- ach. Position the ring this far above the skin 16 5 GASTROSTOMY CARE GUIDE GASTROSTOMY CARE GUIDE Feed Port RETENTION BALLOON CONSTIPATION Besides anchoring the tube GASTROINTESTINAL Inactivity, a change in formula, inside the stomach, the balloon DISTRESS helps to keep the stoma from medication, or feeding routine can cause constipation. A leaking. The 20 cc label on the DIARRHEA balloon port is the balloon Balloon Port physician or dietitian can CAPACITY, not the recom- The most common complication advise the addition of fiber and mended volume. Fill the bal- of enteral feeding is diarrhea. liquid to the diet to correct the loon with 7-10 cc distilled water Possible Causes include the for- problem. or saline. DO NOT USE AIR mula composition, a new med- TO INFLATE THE BAL- ication, or a change in feeding TRACKING PROGRESS LOON. Air will migrate over routine. Other causes may be several hours causing the bal- When tube feedings are first loon to deflate just as a regular rapid formula administration, started, your daily record of balloon gradually deflates. The contaminated formula, or ill- intake and output may help recommended volume for the ness. Try diluting the formula your clinician evaluate the Low Volume Balloon is 2-3 cc. with water and giving it at room nutritional adequacy of the pre- (Fig. 5) temperature. scribed formula and water. For Temporarily decrease the flow SECUR-LOK® the first week or two, and in ill- rate. If diarrhea is severe and CARE AND USE Ring ness, keep a running total of persistent, a physician should daily feeding, water and gastric STOMA AND TUBE CARE direct the care. residual measurement. A To ensure a healthy gastrosto- NOTE: CHECK THE TUBE weekly body weight may be my site (stoma), keep the skin helpful. The cause of poor clean and dry. Wash the area POSITION. IF THE TUBE with soap and water, including SLIPS FORWARD INTO THE growth is an insufficient calorie the tube and the bottom of the INTESTINE, FORMULA WILL intake. SECUR-LOK® Ring. ENTER THE INTESTINE ROTATE THE TUBE 360 DEGREES (A FULL CIR- DIRECTLY, NOT THE STOM- CLE) EVERY DAY TO PRE- ACH, CAUSING VENT THE TUBE FROM DIARRHEA AND OTHER ADHERING TO THE PROBLEMS. STOMA TRACT. Dry the skin surface well after tube care. VOMITING Tape restricts air flow and may Internal This may allow gastric contents break the skin down resulting Retention in infection.
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