? about my peds patient

[bellcollector]

Hi all I am a PDN but this is a peds question. I am caring for a little girl and I do mean little. I won't share anything identifying just in general. She just turned 4 but because of her condition she is very small about 20 pounds. She has severe scoliosis making some of her anatomy a bit off, and a heart condition. She is completely immobile has a G-tube and gets TPN as she has no sucking or swallowing reflexes, and is palliative care. It is very important to me to make her as comfortable as possible. The problem is she has constant gas with cramping. We have tried what we know to do. We keep her at a 30 degree HOB. We have tried formula at night and h2o during day and vice versa. We vent the tube allowing massive amounts of air out. Frequent positioning and simethicone which doesn't work anymore. I am at my wits end. Does anyone have any advice or ideas. I will take what I can get. FYI I am posting this with guardian's approval. TIA

[caliotter3]

In similar circumstances we got an order for Farrell bags, don't recall if they were remarkably useful but think they helped somewhat. As I vaguely recall, what helped the most was continuous venting (which we also got an appropriate order for).

[pghnurse07]

Absolutely try a Farrell bad. Nearly all of our patients use them. You can use it while feeding too. Also what type of formula is she on? She could have a reaction to that.