G-Tube

[Supernrse01, BSN]

I have a student with a new g-tube. This is my first go with one in the school setting and I'm trying to be sure I have all of my legal ducks in a row. What has been your experience with what we can and cannot do if the tube were to be accidentally pulled out or dislodged? I'm hearing both reinsert and don't. Any help you can throw my way would be greatly appreciated. I'm very hesitant to attempt to reinsert. Very. 

[LikeTheDeadSea, MSN, RN]

Have a Reinsert order on file. 

Some kiddos require immediate dismissal to follow-up with their doctor to confirm placement via imaging, some do not.   I've had an array of students over the years, get the paperwork from the doctor and stick to what it says.

[MHDNURSE]

Our orders are to cover the area with gauze to keep clean and call home.  None of the students I can think of have reinsert orders.

[cowboysandangels, BSN]

We are not allowed to reinsert at school.  Make sure you call parents right away because they can collapse quickly 

[Flare, ASN, BSN]

my last kiddo with one had a re-insert order and I kept a g-tube in a cabinet.  The instruction was immediate re-insertion and call to parent with plans to transport to a specific area ER and to call EMS if parent couldn't be there right away.  

[k1p1ssk, BSN, RN]

It's funny how different settings have different reactions to things. We had a toddler with short-gut in the inpatient unit I worked on who unfortunately lived with us - parents lost custody and due to his dependence on TPN & Lipids, he needed medical placement which were few and far between. He had a g-tube that was used to admin oral meds only and he routinely pulled it out. We all just checked the integrity of the balloon and popped it back in. No checking for placement or anything... I remember the first time it happened I was in complete shock, but the charge was like, yeah, there's no way we're paging surgery every time this happens. 

[Supernrse01, BSN]

Thank you all! I received specific orders and have everything in place and ready. No reinsert here either. 

[JenTheSchoolRN, BSN, RN]

I have one kid here with one. No reinsert orders. I just cover and call home if it happens and Mom would pick-up and follow up with doctor. 

(This student does also eat at school - g-tube is supplemental.)

[icepackstat, BSN, RN]

My daughter had a mickey g-button for 3 years.  We have lots of g-button stories! It came out at McDonald's one time and my son found it in the playland.  Eww.  The worst time was she lost it at church one morning but I didn't know it was gone until I went to feed her when she went to bed.  I couldn't put it in, so it required an expensive ER visit.  The awesome ER nurse was able to squeeze it in!  If they had not been able to put it in, it would have required surgery.  As a mom, I would really want the school nurse to sick something in, even if the balloon wasn't working.  Just tape it in place!  As a nurse, be sure to follow doctor's orders!