Thursday, April 10, 2008

G-Tube 101

Over the past few years I’ve had quite a few questions on exactly how the feeding tube works and how we attach it. Everyone we “know” (on message boards with children with special needs) seems to have a certain way of securing their child’s feeding tube which works for them. We’ve tried numerous ways but each has its own drawbacks. We keep coming back to this way though. Pros: It holds well, she can’t take it off. If her tube snags on something it pulls on the tape/skin first before pulling on her stoma. Cons: It takes a bit more time to set up, it is more expensive for supplies, and it takes up more space on her stomach. Below is a picture tutorial of how we get Emma’s feeds ready for the day and secured to her.

Here are all the supplies I have ready before I get started:

Before I do anything with her I fill the feed bag.

The bag is then “burped” (turned upside down so the bubbles float up and then primed a bit) to get out any air bubbles which will cause her pump to error and is also “primed” to get her formula through all of the tubing before being connected to her.

I then attach the extension (part which connects to the actual AMT button and also to her feed bag. The red “Christmas tree” part of the feed bag connects to the blue part of her extension. The opposite end of the extension connects to her button. I also prime the formula through her extension at this time.

Next, I put down a layer of hydrocolloid dressing (or Duoderm depending on which I have). This protects her very sensitive skin from multiple tape changes. We try to make this bottom dressing last 3-5 days to help protect her skin. We also switch which side of her g-tube this bottom dressing goes on with each dressing change.

I then connect her feedbag and extension to her button. This locks into her button by turning the extension clockwise.

After this I make a loop in the extension and place it on top of the hydrocolloid dressing. The loop helps the tube from being pulled out from the tape which I’ll put over it. I also use Hy-tape (the orange tape) to keep the loop in place.

After securing the tube I use a layer of Tegaderm, which is a very thin tape which goes over her tube and the bottom dressing to sandwich everything together. I’ve found using this method is the most secure.

After securing her tube I put the feed bag into the pump as shown and close the door and begin the feed.

Emma is an active toddler so we have the Zevex enteralite Infinity made especially for mobility. It is lightweight, does not have a drip chambers, and has few errors.
I put her feed bag and pump into her backpack and she wears her backpack all day. She loves her backpack and enjoys helping in care of her tube and always fastens her “seatbelt” across her chest to help evenly distribute her weight.

So, that’s the logistics of her feeding tube, what we do everyday and how it is worn. Overall, it takes about 10 minutes to get her set up.

1 comment:

loraine said...

Man o man, Emma is such a cutie. She seems a blend of both of you. It's nice that she likes her backpack.

Again, Elaina and Sean, I am amazed at how well you both handle everything, esp. at your ages. Ya'll are outstanding parents.

Hang in there. It's okay to break down. It's great that you are teaching all who read Emma's blog about what happens with a special needs child, and what happens to ghte family. Very cool.

Write me if you need to do so. I'll get back to you within a week. So wish ya'll lived closer.

loraine and vincent wesley "VW"