Meds and a G-T patient

[buggybum96]

Correct me if I'm wrong....please! As an LPN graduate from the class of 2008, did someone, somewhere change the administration of medication concept for a g-tube patient? Today, I was informed by a much older "experienced" LPN that we "are not supposed to give medications via gravity to a GT patient." They are supposed to be given bolus via syringe even though the Plan of Care does not specifically indicate this. I've been administering all meds via gravity with flushes. And just to clarify...I really do know the correct method of using gravity to administer all prescribed medications (liquid and crushable meds). I just couldn't believe this was told to me.

Am I crazy?

[No Stars In My Eyes]

So, this isn't about technique, however I just have to add this hard earned information: Do NOT ever, ever, ever give cough medicine via GT without first clearing the tube of all formula, and follow the cough syrup with a tube-clearing of water.

One time I just poured the cough syrup (gravity) into the tube that still had formula in it.......it turns into this immovable GLOB of tenacious crud which you can not flush in any way, period!

I hate to tell you what I did to finally clear the tube! I was doing a home-health visit waaaay out in the country/boonies; the patient was poor, had no transpo OR inclination to go to the hospital to have the tube replaced....I had a family member file the point off a metal shish-kebab spit, then sterilized it in boiling water, and slowly moved the crud through the tube enough to give the water bolus a head start.....it finally cleared, much to everyone's relief, without harm to the GT or the patient.

[JustBeachyNurse, LPN]

So, this isn't about technique, however I just have to add this hard earned information: Do NOT ever, ever, ever give cough medicine via GT without first clearing the tube of all formula, and follow the cough syrup with a tube-clearing of water.

One time I just poured the cough syrup (gravity) into the tube that still had formula in it.......it turns into this immovable GLOB of tenacious crud which you can not flush in any way, period!

I hate to tell you what I did to finally clear the tube! I was doing a home-health visit waaaay out in the country/boonies; the patient was poor, had no transpo OR inclination to go to the hospital to have the tube replaced....I had a family member file the point off a metal shish-kebab spit, then sterilized it in boiling water, and slowly moved the crud through the tube enough to give the water bolus a head start.....it finally cleared, much to everyone's relief, without harm to the GT or the patient.

Sometimes coca cola or ginger ale will clear the crud clogs

[icuRNmaggie, BSN, RN]

Colace liquid and warm water will liquefy a curdled TF clog.

I have never given meds via a GT by gravity. Gravity is for bolus feedings. Using a syringe and flushing before and after is far more efficient.

Using a syringe reduces the chance of creating a clog of crushed meds, syrupy liquid meds and the thick high carb high fat high protein TF product.

I learned the hard way too to dilute the syrupy meds in water to avoid any sticky residue inside of the tube.

[No Stars In My Eyes]

Sometimes coca cola or ginger ale will clear the crud clogs

Didn't work on my pt's clogged GT.

[perfectbluebuildings, BSN, RN]

In pediatrics, on my unit, we flush the GT first with 5-10 mL sterile water. Then give each med in a separate syringe, given via "push" method (unless the parent requests otherwise, or the med has to be mixed in a large amount of diluent in which case we'd give all the other meds first, then do that one by gravity). Then flush at the end again with 5-10 mL of water (or whatever it takes to clear the last med through the extension; sometimes that's a little more than 10 mL). Almost every patient I've had has tolerated that just fine, but for those who don't, then we would of course change to giving all meds slowly by gravity.

[loriangel14, RN]

Where I work we always push with a syringe with a good flush before and after.