New G-J tubes

[all4ofus, ASN, RN]

I am a meg-surg nurse. Occasionally, we receive patients from IR who have had new G-J tubes inserted. Each time we have received one of these patients, the G port comes to me with a gravity bag already in place, and the J port is capped. Each time, we inevitably receive orders to start tube feeds to the J port. The problem is that there is always a hard, white, plastic piece inside the J port that does not allow either a Lopez valve (stopcock) or the tube feed connector to go far enough into the tube to grip and stay in place. This results in workarounds, normally involving tape, which is an infection prevention breech, and also not very effective and is very messy, because it doesn't really work. I called our IR department to inquire about this, and was told that there is a "tool" that they use to remove this plastic piece from the G port prior to attaching the gravity bags, but on the floors, we just have to wiggle the plastic piece out (which we haven't been able to conquer!). So my questions are: 1. What is this "tool" that removes this plastic piece? 2. Why not remove it from both ports prior to transfer? One person told me it is meant to stay in place on the j port, but couldn't tell me what purpose it serves, other than impeding adequate connection with tube feedings. 3. What brand(s) do you usually see on these? I would like to track down packaging, manufacturer, and any instructions that are with it. Thanks!

[dianah, ASN]

I would vote for a staff inservice (even for one or two "super-users") from IR or from the manufacturer.

Perhaps IR could send someone to see what you are dealing with, and the fix might be VERY easy.

A meeting of minds, so to speak.

They MUST think beyond their scope, to the nurses that will care for the patient with this new "tool" (the G-J tube).

My opinion. :)

[8-ball, BSN]

I know this is an old thread but I am going to try and answer this question for you today...I will get back to you

[8-ball, BSN]

Ok so here is what I found out Kimberly Clark makes our G/J tubes and as far as our person knows there is no "tool" to remove the white valve but she does know that some doctors remove it (un sure how). What she said is that white valve was placed a few years back when these maufacturers went to the kangaroo pumps with smaller tubing. Previously they had mickey buttons which would lock in, these new ones do not so the valve was created with a reverse christmas tree so that you could place different size tubes inside it and it would be secure.

I know the problem you are describing and I think the issue is with the valve being too low in the tube some times. I would like to see one of the valves not inside the tube. I hope that helps.

[zoidberg, BSN, RN]

i know this is old... i have seen our pancreatic surgeon take that ring out in 2 seconds with a pair of hemostats

[guest940422]

i know this is old... i have seen our pancreatic surgeon take that ring out in 2 seconds with a pair of hemostats

the hemostats can crack the jtube, I've had luck using two turniquites hold the tube with one and the valve with the other (think like the rubber disks you use to get the lid off the pickle jar) this also works really good for loosening central line caps before you change them (loosening not removing a tourniquet isn't sterile!)

If you can't get it off I'd have the surgeon come do it or someone from the team. I'd rather delay feeds or piss off the doctor than be the reason they have to go back for another g/j