enteral feeds & Supplies question

  1. OK, I've been doing HH for 2 1/2 years now, I have only had one of my own pt who had enteral feeds, and he just could NOT understand how to use the pump, so we ended up doing bolus feeds.

    So, maybe I am stupid, but I have to ask this ?.
    How often do you change the feeding bag for a G-tube feed via pump, or gravity? I thought they could be washed and re-used like the way pt's rinse and re-use bed bags and leg bags for foley's and SP tubes, I mean the bladder is more sterile than the GI tract , so my thinking was if they could do that for GU equipment, why not for GI? I had instructed a pt to rinse the bag with warm water thoroughly, then, allow it to rinse by running through the tubing til clear, then let dry. The next nurse freaked out, saying they must only use the bag for 24 hours. I felt like an a$$! Then I checked with the DME company and even Medicare will pay for 30 bags to be sent a month! I was shocked!

    Now what I want to know is, why? I mean, bacteria, yadda, yadda, OK, but if pt's can do this with foley bags, why not GI feeding bags, and discard after a month. Anyone know if any studies were ever done? I know in pt's with atrophy of gastric mucosa, gut translocation of bacteria can occur and lead to sepsis, but that can also occur in the GU tract, pt can develop sepsis from untx UTI. I am just trying to understand the rationale. What am I missing??
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    About hoolahan

    Joined: Dec '99; Posts: 3,786; Likes: 129
    Quality Nurse & Home Health Nurse


  3. by   lpnandloveit1
    we change gravity feed bags every 24 hrs. The problem is those darn corners. and that itty bitty tubing. the feeding can get in them and the drip chambers. Also cleaning with soap and water can leave soap residual. We wash between feedings by the way. I did a case were mom didn't clean the bag between feeding .... stinky!
  4. by   hoolahan
    Thanks lpn....,

    I had a pt who left food in the bag for over a day...peeeeuuuu!!!

    Anyway, love your picture under your name!!!
  5. by   NRSKarenRN
    Learned this when my HH agency had DME company. Formula has protein that can breakdown when heat and air exposed after 8 hours increasing risk for bacteria formation. Also as above, particles stick inside bag, causing inaccurate flow, especially if pump used often causing too little volume to infuse if not aggressivly rinsed. Too many patients lack adequate cleaning so MC agreeable to daily bag change. If I have highly compliant family, would ok change every other day with MD informed. Too often I see sticky nessy enteral pumps cause famuly dumped in can and spilled on pump without wiping.

    Oh the stories I can tell after 16 yr in home care! But who wants to listen??

    PS: Hoolahan, love the new aviatar lips! LOL, ROTF!!!!! Glad to see you smilin' now.
    Last edit by NRSKarenRN on Jul 3, '01
  6. by   hoolahan
    Thanks Karen. The things I learn here!

    At least we are old enough to remember "Hot Lips" Hoolahan from M*A*S*H. That was why I chose them!! Hope it's not too-too for the BB!
  7. by   MALE RN, OTD
    Hey Margret H. Love the "Lips" ! Remember the story I told you when I went to see the movie? Some of my Nursing Instructors wer sitting behind us when we were comparing "them" to the characters in the movie? I'll always remember those days fondly. Take care and have a happy and safe 4th. We're sharing the same kind of weather simce we're so close.
  8. by   mercadies
    Hi is anyone out there, I asked a silly question and I am hoping for a response from those of you who I know will answer me openly and honestly, I seem to have lost my question so here it is again "Should coca cola be given via enteral feeds?" I am aware that this practice is happening out there in the community and is apparently instructed by an RN.... Ideas please!!! Mercadies is concerned for the impaired
  9. by   annaedRN
    I think in general that enteral feed/tubes is ENTERING the body where foley bags/tubing is EXITING or just collecting. JMHO. Not sure about the Coke though - I know that it is widely used..just make sure it is not contraindicated for patient. It does work though, doesn't it?
  10. by   mercadies
    dhyser96, thanks for the response to my querry, I have discussed my concern with the 'professionals' they say it is unheard of in NZ however I hold grave concerns for those who cant speak for themselves. Has anyone else heard of this practice, that is the coca cola plunge????? Mercadies
  11. by   HmarieD
    Coca Cola flush is common in the Midwest, something about the acidity and/or carbonation can really break through a dried clump of TF or medication. If pt is diabetic, we use diet, works just the same.