This can cause kinking. Flushing the Tube To flush the G-J port of your tube, slowly push warm clean tap water into the side opening of the G-port or J-port of the connector. The syringe may be washed in warm water, air dried and reused. Medication or Feeding Your doctor or nurse will give you instructions through what port medications and feedings should be given. Be sure to follow their instructions carefully. Do not mix medications unless you are instructed to do so by your doctor.
Here are some suggestions: Keep the tube taped or pinned to the diaper or shirt. Keep the child's T-shirt over the tube. One-piece, snap T-shirts work best for infants and toddlers.
An alternate way to cover the tube is to use an ACE wrap or stretchy gauze over it. Most children get used to the tube after a while, but until they do, they may need to wear elbow splints if necessary.
Be sure to keep the end of the tube closed as directed. Problem Solving The following is an emergency problem that can occur with a G-J tube. Emergency problem : G-J tube is forcefully pulled out. Problem What to Do G-J tube site is red and sore or has green or white liquid where the tube enters the skin. Clean as per instructions. Call your child's doctor immediately. A surgeon puts in a G-tube during a short procedure called a gastrostomy.
The G-tube can stay in place for as long as a child needs it. Kids who have had a gastrostomy ga-STROSS-teh-mee can get back to their normal activities fairly quickly after they have healed. Doctors often order several tests before a child can get a G-tube. The most common test is an X-ray of the upper gastrointestinal GI system.
This lets the doctor see the upper part of the digestive system. Sometimes the surgeon asks the family to meet with specialists, such as a gastroenterologist, dietitian, or social worker. This is to prepare a care plan so everything will be set up when the child goes home with the G-tube. To get ready for the procedure, you will need to carefully follow instructions about when your child must stop eating and drinking.
When you get to the hospital, the doctor will describe what will happen and answer any questions. The anesthesiology team will ask about your child's medical history and when your child last ate and drank. Before the procedure begins, the care team sets up monitors to keep track of your child's vital signs like blood pressure and oxygen level and puts in an intravenous line IV to give medicines and anesthesia.
Your child will go to the operating room, and you'll go to a waiting area. A hospital staff member will tell you when the procedure is over. Kids usually stay in the hospital for 1 or 2 days. A balloon is inflated inside the stomach to prevent the tube from falling out. A disc is pushed down on the outside portion of the tube to also help keep it secure and prevent it from sliding in and out of the opening.
One port is for the stomach gastric port , another is for the intestine jejunal port , and the last one is for the balloon. G-J tubes are replaced using x-ray guidance to make sure both the gastric and jejunal portion of the tube are in the right place.
Check the opening stoma site and surrounding skin closely once a day. A little drainage and redness at the opening is normal. Clean the stoma daily with unscented soap and dry the area well. If a low profile balloon button GJ device curls back into the stomach, the entire device needs to be replaced. When feeds and fluids can be introduced will depend on the type of device that has been inserted and whether you previously had a gastrostomy:.
The dietitian will discuss with you the most appropriate method of feeding. This depends on your medical condition, the particular needs of your family, and your home circumstances. As the jejunum cannot hold feed like the stomach, feeds will be continuous given over a long period of time using a feeding pump so that the jejunum has time to absorb nutrients.
You will be prescribed a special liquid feed, which contains all or most of the nutrients you need. Please talk to your dietitian if you would like to know more about it.
Your doctors and dietitians will talk to you about this. We will show you how to do this. Gastrojejunostomy devices are not suitable blended food, as the small size of the tubes holds an increased chance of blockage and complications. Once you have fully recovered from the anaesthetic if you have had one and are tolerating feeds well, you will be able to go home, unless any other procedures are planned.
The feeds, equipment and other supplies should have been organised by your local team before coming to GOSH, so you should be able to start tube feeding straightaway once you return home.
They will also have taught you how to prepare and give feeds, look after the gastrostomy site and spot any problems that occur. If you have any questions or problems, please contact your local team in the first instance. You may need to go come back to GOSH for the device to be moved in another operation under general anaesthetic. The device will need some extra care to keep it working well and reduce the risk of infection. We will talk to you about this before you go home and your community team will also be able to help.
Check that the button is fully closed or the tube is clamped before having a shower or bath. Always make sure that you dry around the GJ, as any dampness can breed bacteria and develop into an infection.
Unlike gastrostomy tubes and buttons, GJ devices should not be rotated as this could move the position of the tube in the jejunum and cause kinks in the tubing.
You should not need to check the position of the GJ device before each feed, but if you are concerned that it might have moved, you can use pH paper to check a sample from the jejunal port. You should flush the device as you have been shown before and after feeds and after giving medicines.
We may give you a spare nasogastric tube or gastrostomy device to take home with you. If the device falls out, you will need to insert the spare tube or device into the opening straight away - otherwise, it will close. The nurse will advise you about when it is safe to do this. You will receive further supplies from your community health care team, your local paediatric community nurse if your area has one , your dietitian or your GP.
If you have any problems getting hold of further supplies once you are at home, please ring the hospital. You should remember to order new supplies in good time before you run out and only use equipment for the length of time specified by the manufacturer. Using or re-using equipment against the advice of the manufacturer could lead to infections, diarrhoea and vomiting, which cause could harm. There are no special requirements for disposing of gastrostomy supplies such as giving sets and enteral syringes — they can be put in your usual household rubbish, although we suggest you put them in a separate plastic bag before putting in the bin.
When medical staff are prescribing medication, remind them about the GJ. Tablets may block the tube, so liquid medicine would be better. If you need to give medicines in tablet form, make sure they are finely ground and mixed with cooled boiled water.
You can buy a tablet crusher from your local community pharmacy to make this easier. Most medicines should be given into the stomach port. However, if medicines cannot be tolerated by the stomach, they can be given into the jejunum, but you should discuss this with your doctor or pharmacist first to ensure that the medicine can be absorbed properly by the jejunum and that the volume of medicine is not too large.
Some medicines can also block the GJ, so again, check with the pharmacist if you have any concerns. Always flush the GJ with sterile or cooled, boiled water after giving the medicine you will have been shown how to do this by the nurses on the ward. If you are giving two types of medicine, flush the GJ between each type. You should still continue to clean your teeth twice a day and visit the dentist regularly. If your mouth feels dry and you cannot safely have a drink, a fine water spray bought from the chemist can make your mouth more comfortable.
Lip balm can help dry cracked lips. You should be able to go to school or nursery as usual.
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