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This is a tough one. How is all that air getting into her stomach? Could it be she's intolerant of her current feed? There are some antispasmodic meds that might help, but they have significant anticholinergic effects as well. Bentyl and Robinul are two. You might also try warm blankets or a hot water bottle on her abdomen. That's about all I've got...
I used to do PDN and my patient was having a lot of gas. He also had a lot of vomiting. His formula had been changed recently, so no surprise there. We ended up slowing the feed significantly. I would also lay him on the floor and rotate his legs as if he were on a bike. Think about a post-op patient who really needs to pass gas - if they are able, first thing you do is get them up and walk! My patient (and yours) couldn't do that so we have to do it for them.
Other than what you're already doing, I don't have anything else to offer. In regard to the robinul, I'm not sure that would be more useful - it just made my patient constipated.
I just watched video on the
Farrell bag as well I will show it to guardian's in the morning. I am giving the simethicone every 4 hours, have vented tube before each dose, have HOB elevated as high as is comfortable for her and am frequently positioning. So far so good. Thank you for the responses all are appreciated.
bellcollector
239 Posts
Hi all I am a PDN but this is a peds question. I am caring for a little girl and I do mean little. I won't share anything identifying just in general. She just turned 4 but because of her condition she is very small about 20 pounds. She has severe scoliosis making some of her anatomy a bit off, and a heart condition. She is completely immobile has a G-tube and gets TPN as she has no sucking or swallowing reflexes, and is palliative care. It is very important to me to make her as comfortable as possible. The problem is she has constant gas with cramping. We have tried what we know to do. We keep her at a 30 degree HOB. We have tried formula at night and h2o during day and vice versa. We vent the tube allowing massive amounts of air out. Frequent positioning and simethicone which doesn't work anymore. I am at my wits end. Does anyone have any advice or ideas. I will take what I can get. FYI I am posting this with guardian's approval. TIA