Farrell valve with a GJ tube for medications?

[ememily2004]

Good afternoon all,

I started with a new pediactric home care client today and travel with him to school. My client has a GJ tube and is off his continuous feed during his school hours. I have given medications through G tubes countless times, but the client's mother says she hooks up a Farrell Valve to administer meds at home. I have only seen a Farrell Valve once before and it was used as a "burp" bag for feed intolerance to prevent distension and dumping. I have scoured the internet looking for information about using the valve strictly for medications and have found nothing useful. Any ideas or information you can pass on would be most appreciated.

[NicuGal, MSN, RN]

When we leave it on we just use the GT port as usual, clamp it off and them open it 30 minutes later. Does he need it as a burper?

[classicdame, MSN, EdD]

I hate that nurses are supposed to know the ins and outs of every single piece of equipment out there, without benefit of an in-service. I believe your agency should require either an MD order on how it should be done or the mfg rep should supply the agency with in-service training materials. There is always a liability with learning from a lay person (caregiver). They do not have a license to risk.

[JustBeachyNurse, LPN]

Defer to the education unit at your agency. There should be a specific protocol. I had a patient JT for food, GT for meds. If the Farrell is primed properly and positioned properly it can be left in place post medication administration but you need to watch for the medication to be expelled into the tubing. Depending on why, sometimes clamping for 30 minutes is appropriate sometimes it is not (i.e. if there is a lot of gas and the medication is going to be regurgitated as a result the Farrell can relieve the gas pressure so the medication can be absorbed). You really need to get a clarified order from the physician as this is definitely dependent on the patient and indication. My patient's meds were split GT & JT depending on what med and why it was given, and the composition (sugar base, sorbitol base, etc.)

[wooh, BSN, RN]

I've done this. When you've got a tube that has only a port that you can use "big" syringes on, and want to use the little oral syringes to administer meds, you can use the little port on the ferrel bag to give the meds. (At least with the couple brands of ferrell bags that I've used.) Just hook the ferrel bag up, clamp above the port on the ferrel bag, and make sure you flush enough to clear the ferrel bag. That way you don't have to use a giant syringe to give the meds.

[JustBeachyNurse, LPN]

Thread moved to private duty nursing forum to elicit further response. I just want to reiterate to contact you clinical manager, clinical educator and/or patient's physician to clarify the order. It is different in the home environment, but you still need specific orders for skilled nursing care, especially if it is a deviation from standard care.