Peg tube placement

[Carocoho1234]

I had a patient last night at the LTC facility I work at that had a peg tube split open. I sent her out to get it replaced since she is NPO. I got reamed by my boss because she wanted me to replace the peg myself. I was told in the past that nurses cannot do that because we cannot check placement via xray.

Am I wrong?

[KelRN215, BSN, RN]

Was it a PEG with a crossbar or a tube with a balloon? And did you have a replacement tube on hand?

G-tubes replaced in existing tracts do not typically get XR confirmation, in my experience. In pediatrics, our patients have MIC-Key buttons or AMT tubes and parents are taught to replace those q 3-4 months at home.

[CoffeeRTC, BSN, RN]

Was it a PEG with a crossbar or a tube with a balloon? And did you have a replacement tube on hand?

G-tubes replaced in existing tracts do not typically get XR confirmation, in my experience. In pediatrics, our patients have MIC-Key buttons or AMT tubes and parents are taught to replace those q 3-4 months at home.

We haven't had residents with feeding tubes for years, but often times we were able to replace in the facility and then call for an xray to verify placement.

[amoLucia]

Yes, you may have been wrong.

Did you check your P&P to determine if indeed you could replace the Gtube? WHO was it in the past that told you couldn't change the tube? Ahhh, that ambiguous person ... Does your P&P stipulate that an xray is required? In LTC, xray is usually not readily avail on NOC so a delay could have MAYBE been OK.

However, did you need to use the tube during the night? Was the pt unstable diabetic, on critical meds? Did you have all the required equip nec for replacement?

For the future, a better move would have you consulting a supervisor or your ON-call Resource/DON.