Continuous enteral feeding

[CKlamm]

I work in a long term rehab facility and have several pediatric patients on continuous enteral feedings. I am looking for advice on how to keep them at the 30 degree angle when they are in the crib, they are very mobile. They are checked and repositioned frequently and sit in chair for part of the time. Any ideas? Thanks

[NotReady4PrimeTime, RN]

It's a very difficult thing to keep active children from moving around. If they're awake and moving around it's a bit different from when they're asleep, and it's kind of a losing game. Being up in a chair or being held eliminates the need for positioning, obviously. When it's time for sleep there are a few things you can do. I use a lot of flannel rolls as bolsters, both to keep them from sliding down in bed and to keep them on one side or the other. For the really little ones, I'll make a big, long roll then shape it into a U, tucking it under the bedding. Turning them is as simple as lift-and-flip. For the bigger kids, the bolster under their bum needs to be big enough to have their hips at 90° to the head of the bed. It's more comfortable and will help them stay put longer. Another fairly large roll that runs from behind their head to their coccyx will give them something to lean against and help them stay on that side. Tucking the bolsters under the bedding help them to stay where you put them and is also more comfortable. A thin pillow under their head will position them so that their neck doesn't get sore. Of course there are commercial positioning aids but they're not always available. Flannels usually are.