Topics covered in this article
- What to expect from G tube surgery & after surgery
- Reasons a G tube is needed
- Feeding supplies
- Training on equipment
- Step by step how to use a feeding machine and G tube.
- Step by step how to change a G tube
- Helpful tips
G Tube Surgery
When your child undergoes any surgery including G tube (Gastrostomy) surgery, it is nerve wrecking. Because of the unknown, you are nervous and worried about the upcoming surgery. You are afraid your child will not understand or know what is coming. And you feel helpless. Plus, the morning of the surgery, your child will not be able to eat or drink anything after a certain amount of time before the surgery. As a preparation for the surgery, a nurse prep your child by providing a hospital gown, starting an IV and checking vitals. The nurse will also ask you questions about the patient. Lastly, the doctor’s initials are written on the surgical sight which the G tube would be placed. Then you say goodbye to your son or daughter. The surgery usually takes 30- 45 minutes.
What to Expect After Surgery
As a parent, you feel relieved once the surgery is completed. After G tube surgery, your child will unfortunately be uncomfortable and experience stomach pain. However, he or she will be given pain medication and be well cared for. Additionally, your special one will be drowsy and not alert. Immediately after surgery, your child will be hooked up for a slow continuous feed for her body to get used to the G tube feedings. Your child will have a two day hospital stay.
Reasons Your child needs a G tube
- Has a disability or condition such as Cerebral Palsy or brain injury and does not have the muscle coordination to swallow and digest food and drinks properly.
- has difficulty swallowing or aspirates while eating or drinking.
- takes a significant amount of time to finish his or her meal.
- Has difficulty drinking an efficient amount of water and fluids.
- is not gaining weight or growing according to their age and standardized growth charts
- becomes ill frequently due to lacking good nutrition.
Training about using the G tube and caring for your special one will be provided from the hospital staff. They also will have you watch some videos about the G tube and how to care for your child. The nurses will give you detailed handouts about optional formulas available including the ingredients. There are formulas that are dairy or nondairy based. Additionally, you will meet with a nutritionist on staff at the hospital about the formula your child will receive. A discussion will occur in regards to the amounts of formula and water he or she will need daily based on their age and weight. When your child is ready to go home, the nurse will review the discharge instructions and paperwork with you.
During your first doctor’s appointment with the surgeon, the nurse will teach you how to change your child’s G tube.
Equipment such as a feeding pump and pole, feeding bags, extensions, syringes and formula will be delivered by a provider such as Coram. On a monthly basis, you will need to contact your provider and order a resupply of feeding supplies which will be shipped to your home in about 2-3 business days. Every 3 months, a G tube kit will also be included in your resupply. http://www.coramhc.com
There are 2 types of common feeding pumps:
Steps to Begin a G tube Feeding
- Pour formula in a funnel into a plastic bottle with a screw top. Second option is to pour the formula directly in the feeding bag, which can be messier.
- Transfer the formula from the plastic bottle into the feeding bag. .
- You have the option to squeeze the bag to remove excess air but it’s not necessary.
- Screw the cap on.
- Prime the line (tube) of the feeding bag by pressing “prime” on your feeding machine.
- Line up the 2 lines, (1 line on the extension and 1 line on the G tube). Next, turn the extension clockwise to lock it.
- Unscrew the white cap at from the tube of the feeding bag.
- Connect the feeding bag tube to the extension by screwing the purple end of feeding bag to the extension. The extension should be unclamped before you begin the feeding.
- Press “run” on the machine
- When the feeding is completed, the feeding machine will beep until you press the off button. Then you will disconnect the feeding bag tubing from the extension.
- Put the white cap back on the feeding bag tubing to avoid leakage and keep the tube clean.
- Screw on a syringe of water to clear the extension & push an amount of water through the tube.
- Clap the extension and remove the syringe 💉
- Remove the extension from your child’s G tube by turning the extension clockwise to meet the lines again.
- After each feeding, rinse out the feeding bag and prime water through the line for a few minutes then press “run” for 15 -20 minutes.
How to change a G tube
- Wash your hands.
- Open your G tube kit.
- Put petroleum jelly on the end of the new G tube and then put it on the gauze.
- Insert the small syringe on the side of the G tube and pull back the water in the balloon of the G tube. Disregard the old water in the G tube, balloon.
- Remove the old G tube gently.
- Immediately and quickly put in the new G tube in the site to avoid the hole from closing.
- Put the small syringe full of 4 cm of water in the side of the G tube to inflate the balloon.
- Remove the syringe.
- If your machine beeps and states ”no flow”, troubleshoot by looking over the feeding bag tube or extension tube and make sure the tube is not twisted anywhere. If so, untwist the tube and press the tube until it’s straight again.
- Disconnect your child’s extension and feeding bag before you move her/ him.
- Double check to see you lock the extension. Otherwise, formula will spill.
- Stay organized. Have a designated spot for every equipment, feeding supply then they are easily to find and utilized.
- Contact your provider such as Coram http://www.coramhc.com a few days before the end of the month and before you run out of feeding supplies.
- Bring extra supplies such as feeding bags, formula when you go out in the community, just on case of a problem occurs.
- Throw out your feeding bag once a day.
- Change your child’s G tube every 3-4 months.
- Change your child’s extension every 1-2 weeks depending on how many extensions are provided to you by insurance.
- Check the water in your child’s G tube balloon once a month because it has a tendency to lose water.
- Never put regular milk or any other food item through the tube. If you do, the extension will be ruined and will not work.
- Give your child medication through the G tube.
- Always clap the extension after put medication, water or formula through the tube. Otherwise, the extension will leak.
- Have a towel near by in case there’s leakage or for your child if they have reflux.
- Put bandage tape on one of the outputs of the extension to avoid the cap coming off, leakage and messes.
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