[CanuckStudent]

Hello...I need some "tips" if you will, please. I am a *very* new nursing student, and I am planning to apply for a position which would require me to tube feed a young child (G tube).

I really would like to get this position, as it would fit around my course load quite well.

I already have quite a bit of past experience volunteering with severely disabled and developmentally delayed kids (and LOVED it!), so that is not a problem. However, I have ZERO experience or education (yet) with any kind of feeding tubes. I just would like any tips or helpful advice from any of you "pros" out there.

(Note: The position does not require licensed personal, similar to how parents of a Type 1 diabetic child will train caregivers to test blood glucose levels, count carbs, and/or inject insulin, etc.)

I think I would love this position! A student's dream! Please wish me luck!

Thanks.

P.S. Does anyone know where I could find a clinical video demonstrating a G tube feed/care?

[nanacarol]

Hi, for the video, Google it!! I am sure there is a virtual video out there some where. Better yet why not aks to volunteer with the family or a family who has a child with this need? Nanacarol

[dhyser96]

Occasionally youtube will have a video like that. Also,most of the fundamentals of nursing textbooks have step by step directions in them - if you have one or a friend has one.

[janfrn]

G-tubes are pretty straight-forward. Since they are placed transcutaneously into the stomach, placement isn't usually a big concern. Until a few months ago, I would have said NO concern, but then we got a little boy in our PICU whose tract hadn't formed properly so when they put in his first Mic-Key it caused the abdominal wall to separate from the gastric wall and the family, not knowing this was possible, had been feeding him into his peritoneal space. With predictable results. He ended up in PICU for several weeks, made four trips to the OR for washouts and nearly died. So I suggest that you assess the site carefully at the beginning of each shift to ensure that it's really where you think it is. Aspirate for stomach contents every so often too, since the stomach acts as somewhat of a reservoir and there will be at least a few mls or residual feed in the stomach. You'd never be able to aspirate back feeds from the peritoneal space.

Always have clean hands and clean equipment. Measure volumes carefully; home nutrition plans make calculations on a regular basis so that the child grows appropriately and achieves adequate nutrition, but doesn't turn into a Weeble. I would guess this boy is bolus fed, so at the end of each feed the bag will need to be rinsed out and the tubing flushed through. Don't give the feed too fast, or you could end up wearing it. Between feeds make sure the tube or button is properly secured so the kiddy can't pull on it, get it caught in anything, put it in his mouth (or his diaper!) or encourage other curious kids to tug on it. If you're giving meds through the tube, make sure you flush it well afterwards to prevent clogging. And if it falls out or is pulled out, put it back in IMMEDIATELY. The stoma starts constricting almost right away so you don't want to lose any time. Stoma care will probably be as simple as washing it with soap and water in the bath, but he may need a dressing or topical treatment, especially if it leaks. Remember that the stuff leaking out is going to be very acidic and will damage the skin.

Ask his mom to show you all of his equipment and show you how she does things. You'll recognize anything that's obviously wrong. Ask lots of questions, because she's the expert!

[CanuckStudent]

Originally Posted by janfrn

G-tubes are pretty straight-forward. Since they are placed transcutaneously into the stomach, placement isn't usually a big concern. Until a few months ago, I would have said NO concern, but then we got a little boy in our PICU whose tract hadn't formed properly so when they put in his first Mic-Key it caused the abdominal wall to separate from the gastric wall and the family, not knowing this was possible, had been feeding him into his peritoneal space. With predictable results. He ended up in PICU for several weeks, made four trips to the OR for washouts and nearly died. So I suggest that you assess the site carefully at the beginning of each shift to ensure that it's really where you think it is. Aspirate for stomach contents every so often too, since the stomach acts as somewhat of a reservoir and there will be at least a few mls or residual feed in the stomach. You'd never be able to aspirate back feeds from the peritoneal space.

Always have clean hands and clean equipment. Measure volumes carefully; home nutrition plans make calculations on a regular basis so that the child grows appropriately and achieves adequate nutrition, but doesn't turn into a Weeble. I would guess this boy is bolus fed, so at the end of each feed the bag will need to be rinsed out and the tubing flushed through. Don't give the feed too fast, or you could end up wearing it. Between feeds make sure the tube or button is properly secured so the kiddy can't pull on it, get it caught in anything, put it in his mouth (or his diaper!) or encourage other curious kids to tug on it. If you're giving meds through the tube, make sure you flush it well afterwards to prevent clogging. And if it falls out or is pulled out, put it back in IMMEDIATELY. The stoma starts constricting almost right away so you don't want to lose any time. Stoma care will probably be as simple as washing it with soap and water in the bath, but he may need a dressing or topical treatment, especially if it leaks. Remember that the stuff leaking out is going to be very acidic and will damage the skin.

Ask his mom to show you all of his equipment and show you how she does things. You'll recognize anything that's obviously wrong. Ask lots of questions, because she's the expert!

Fabulous answer. Exactly what I needed. Thanks a lot for your input!