PEG tube leaking

[limabean]

I had a pt today with a peg tube that had some leakage around the site. A KUB had been done yesterday and it showed the tube to be in good position. Well when I changed the dressing there was what looked like some tube feeding around the site and on the dressing. Then later when I gave a med thru the tube (which was red), I decided to see if it was still leaking. Sure enough when I lifted the tube upward the red drainage started seeping out. The surgeon had come by early am and had commented in the progress notes "No drainage around g-tube site". (Which by the way wasnt true b/c I changed the dressing about 30 mins later). So I called the doc on call and he said he thought it was alright and that the other surgeon would re eval in am. My question is...how much is too much drainage from the peg tube site? What could be causing this? Thanks.

[catlady, BSN, RN]

Most of the ones I have even encountered are sutured, but I have had to watch a actual foley put in till they could get the pt into surgery to put in another. This is a temp urgent/emergency thing in our facility. (The patient coughed really hard and blew the sutures...ouch!!!!!! Freaked me out! LOL!).

Years ago when I started in LTC, the only kind of G-tubes we saw were Foleys. They were usually 24g or higher, 30 cc balloon Foleys. We changed them once a month and prn, just like urinary Foleys. The only difference was that we snipped off the tip (not the balloon) for better flow. We always remembered to pad the bed, because it could get pretty messy when taking out the old Foley.

[limabean]

Sorry it took so long to post a reply...I was at work all day. It is definitely not a foley type. It has a small flat piece that lays against the skin to help keep it secure....I didnt see any sutures though. No abdomen distension and good bowel sounds. It was not leaking nearly as much today as yesterday. I was able to speak with the surgeon this am...he seemed to be okay with it leaking the amount it was. He was just concerned that it was not leaking stool, and it was not. Thanks for all your replies...I learned a lot about g tubes...I had no idea there were so many types.

[Marie_LPN, RN, LPN, RN]

The kind you're describing isn't the kind that gets sutured in. On the end of the tube, is a mushroom-shape cap that holds the tube inside of the stomach, and the flat piece (sometimes round and flat) slides over the tube on the outside to secure it (and keep it from drifting back inside.)

How long ago was the PEG tube put in?