This is a long-term access procedure in which a tube is placed through the abdominal wall into the stomach of a child so that feeds can be directly delivered into the stomach without passing through the mouth. This procedure can be performed for infants and children with swallowing and feeding difficulties e.g. oesophageal atresia, caustic soda ingestion etc.
Aims
· Provide nutritional support
· Administer medications
Requirements
· Foley catheter (sizes 8-24)
· Syringe and needle (20ml-50ml)
· A glass of water
· Prescribed feed
· Feeding cup
· Sterile gauze
· Examination gloves
· Prescribed medication
· Perfusor
· Mackintosh with towel/bed mat
· Feed chart
Steps
1. Establish rapport (Refer to steps)
2. Explain procedure to child/caregiver(Refer to steps)
3. Provide privacy
4. Confirm physician/doctor’s order
5. Perform five moments of hand hygiene
6. Arrange necessary items for feeding
7. Prepare warm feed as prescribed
8. Place child in a semi-Fowler’s position in bed
9. Fold top linens down to expose gastrostomy tube
10. Wear an examination gloves
11. Place mackintosh with towel/bed mat around the stoma to expose the opening
12. Unclamp the gastrostomy tube and attach a syringe
13. Remove plunger if using 50cc catheter syringe tips
14. Check patency of the tube by pouring a small amount of water into the syringe
15. Stop flushing and inform physician/doctor in charge if water does not flow freely
16. Pour feed into the syringe
17. Tilt the syringe to allow bubbles to escape
18. Add more feed to the syringe when about one quarter of it remain
19. Increase/decrease the flow rate by raising or lowering the syringe
20. Feed between 10-20minutes depending on the type and consistency of the feed
21. Flush feeding tube with 10-20mls of water
22. Clamp tube to prevent leakage of feed
23. Instruct child to remain in a sitting position for 30minutes and semi-Fowler’s position in an infant
24. Express appreciation to child/caregiver
25. Dispose off, decontaminate and clean used items
26. Remove examination gloves
27. Document procedure manually or electronically
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