G-tube leaking :(

Nurses General Nursing

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So I am taking care of an approx 6kg baby girl who it fed via gtube and hers leaks something awful! Due to her resp issues she is positoned prone or on her side 90% of the time, she cannot tolerate her back. She is fed bolus over 90mins during the day and cont olvernight, neither seems to make a difference. Surgery has one already removed the button (mickey) for four hours to make the hole smaller and it seemed to work temporarily but we are back to leaking again. Any suggestions? The site looks great but she is soaking through clothes & blankets, and she in on some pretty important po meds too

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Are you sure the site is leaking and not the tube having a whole in it? If it is the site....to keep her dry seal an ostomy bag around the stoma and thread the tubing through the appliance bag and gently secure the end with tape.

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Are you sure the site is leaking and not the tube having a whole in it? If it is the site....to keep her dry seal an ostomy bag around the stoma and thread the tubing through the appliance bag and gently secure the end with tape.

we have changed the extension tubings a few times now (due to the med port stretching out, and we always have a back up clean one). The bubble inside is filled properly but I never thought of the ostomy idea! To at least keep her dry and get a measurement of how much is leaking! I will try that next time i'm at work, thanks!

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Specializes in LTC, Memory loss, PDN.

In my experience, Mickeys are prone to malfunction with littluns who are prone or crawl and scooch on their belly. Have you looked at other low profile devices?

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In my experience, Mickeys are prone to malfunction with littluns who are prone or crawl and scooch on their belly. Have you looked at other low profile devices?

we are in the nicu, surgery has been consulted a few times and never mentioned a different button, I wonder if our hospital offers them, I have seen the "mini one" which looks a lot flatter and like it would work better since she is prone alot, i guess next time surgery is up we will have to ask

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
we have changed the extension tubings a few times now (due to the med port stretching out, and we always have a back up clean one). The bubble inside is filled properly but I never thought of the ostomy idea! To at least keep her dry and get a measurement of how much is leaking! I will try that next time i'm at work, thanks!

YOu're welcome!

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Specializes in Pediatrics, ER.

We had a baby who had this happen. Does her gtube have a lot of play? Can you insert a larger size Mic? Here a few things we did:

Exudry sponge with Allevyn sponge over it (cut to fit around the Mic), with Mepitac tape reinforced with two strips vertically and two strips horizontally over the sides of the button, to tack it down. We also used duoderm on her belly and secured to extension to that to reduce pulling on the Mic-Key. After that, we placed an ABD over the whole thing, with a surgilast retention band (basically an elastic kerlex type thing that holds it in place), for extra hold. We would weigh the dressing every shift to see how much the baby lost, and replace 1:1 with Pedialyte if it was over a certain amount. We also used stomadhesive powder, Desitin, and Maalox to reduce irritation and protect the skin from gastric contents.

One of our babies was so bad that the doctor ended up inserting an NJ, and placed an ostomy bag around the Mic site to collect the contents because it was leaking so badly. We would refeed the contents every 8 hours through the NJ so that the baby didn't lose electrolytes. In the case of that baby, the only thing that helped was doing this and giving the site time to heal and close. The baby was an extreme micropreemie and was slow to heal.

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We had a baby who had this happen. Does her gtube have a lot of play? Can you insert a larger size Mic? Here a few things we did:

Exudry sponge with Allevyn sponge over it (cut to fit around the Mic), with Mepitac tape reinforced with two strips vertically and two strips horizontally over the sides of the button, to tack it down. We also used duoderm on her belly and secured to extension to that to reduce pulling on the Mic-Key. After that, we placed an ABD over the whole thing, with a surgilast retention band (basically an elastic kerlex type thing that holds it in place), for extra hold. We would weigh the dressing every shift to see how much the baby lost, and replace 1:1 with Pedialyte if it was over a certain amount. We also used stomadhesive powder, Desitin, and Maalox to reduce irritation and protect the skin from gastric contents.

One of our babies was so bad that the doctor ended up inserting an NJ, and placed an ostomy bag around the Mic site to collect the contents because it was leaking so badly. We would refeed the contents every 8 hours through the NJ so that the baby didn't lose electrolytes. In the case of that baby, the only thing that helped was doing this and giving the site time to heal and close. The baby was an extreme micropreemie and was slow to heal.

wow! that is quite the getup! I don't think hers is quite that bad though I am interested in how much she is losing. Unfortunately she isn't leaking anything right now because she's been made NPO d/t being intubated for a cardiac cath and another procedure, and she is a sedation nightmare with a critical airway, it's been a fun day if you can imagine ;) Maybe the rest will help it close a little better and surgery may remove it again to let it close a bit but if all else fails i've got some definite options from you all!

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Specializes in Pediatrics, ER.

Is she trached or did they tube her for the procedure? Critical airway from subglottic stenosis? Poor thing. I hate when our babies have to go for caths. They always seem to bounce back though!

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Is she trached or did they tube her for the procedure? Critical airway from subglottic stenosis? Poor thing. I hate when our babies have to go for caths. They always seem to bounce back though!

laryngeal malacia, a genetic syndrome (w/o getting too specific), VERY short neck and some other anomalies (as well as previous traumatic intubation's at another facility), it was a planned pre-procedural intubation that took 2.5 hours :crying2:

Where are you at?? Our luck with caths seems to be 50/50 with some of our babies doing MUCH worse or dying post procedure :crying2: (but we have had some that we were sure would do bad do wonderfully), I'm pretty nervous, she was supposed to go today but things got pushed, she will go later this week

She will most likely get a trach due to her airway/respiratory issues

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Specializes in Pediatrics, ER.

Laryngomalacia is tough. They're usually pretty stridorous at baseline and it always makes intubations tough. I'm lucky to be in Boston, with some of the best pediatric cardiologists and IR ain the country. The success rate of cardiac caths also depends on what they're doing once they're in. Warm thoughts and well wishes for your kiddo. Its amazing how attached we get in the homecare setting! :)

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I am in a major childrens hospital, they do great with their cicu kiddos but for some reason the nicu ones tend to struggle

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