Last edit by adrienurse on Sep 17, '08
Mar 20, '07
The site is usually a puncture incision. The tube will generally be anchored from the inside; occasionally I have seen a stitch or two to the skin.
Initially there will be scant drainage, usually serous. Occasionally there may be some redness at the site or the drainage is whitish or purulent.
Care usually consists of cleaning around the site with saline or occasionally half strength hydrogen peroxide, then changing the gauze around the tubing (1-2X daily initially, less frequently as the drainage decreases). You may see some crusty stuff around the site at first. If the drainage is looking nasty the Doc might order bacitracin to the site. As for gauze, there may be no drainage around a PEG that's been in place for a while but gauze is used frequently as padding to keep the plastic disc that rests on the abdomen from irritating the skin.
The patient may have a bellyache for a couple of days after placement but should not experience any great discomfort after that. Usually the feed pumped in is passed rapidly through the stomach and the gastric residual will be under 10 cc or so. At my hospital if there is more than 1 hour's worth of feed in the stomach we stop the feed for at least an hour, then check the residual.
Really, really important- make sure to do education with the pt and family re: increased aspiration risk. They will need to remember the pt's head should be elevated at least 30 degrees if the feed pump is running.
Mar 24, '07
ouch...1/2 strength Peroxide? we use no more than 1/4 strength and usually only normal saline. Also, no one should be using Bacitracin. It causes over growth of other bacteria and leads to more resistant strains.