Did I make a MAJOR error?

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Hi all,

I had a patient with a jtube after total gastrectomy with feed running at 90ml/hr for 18hrs/day with 75ml flushes q 6. We were having issues with some non-liquid meds clogging the tube so we got the ok from the surgeon to push meds (I know I know). When I had the pt. I was dissolving the meds in about 60mls of h2o to prevent blockage/per pt request. A day later the patient is presenting with high temp and desating aka I'm thinking aspiration pneumonia? But if I were feeding the pt with too many fluids, would aspiration pneumonia develop that quickly, or am I just being crazy and paranoid?

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Specializes in NICU, PICU, PCVICU and peds oncology.

Unlikely to be related to your med administration. The need to maintain patency of this tube is paramount; having to remove it due to blockage by meds would be a catastrophe and entail another trip to the OR... The tip of a J-tube is in the first portion of the small intestine and after a gastrectomy there should be a purse-string suture in addition to the pylorus securing the tube so reflux of feed/flush/meds shouldn't theoretically be possible. (60 mL of fluid is not quite even two swallows...) Aspiration of saliva is another thing altogether and totally possible. But these symptoms could also represent a pulmonary embolus.

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Aspiration Pneumoniae could develop in 24hrs. Whether it was due to the water/meds or the feeding would require sputum samples & possibly a bronche. Continue to follow aspiration prevention standards & it should be ok. Especially with only bolus items, not continual feedings.

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Specializes in Complex pedi to LTC/SA & now a manager.

duplicate threads merged

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