Handbook of Drug Administration Via Enteral Feeding Tubes

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This technique is often used as part of laparotomy with major gastrointestinal resection. A submucosal tunnel is created through the anti-mesenteric well of the jejunum with a needle catheter after its introduction into the abdominal cavity. The tunnel should be about 4-5 cm. This prevents the development of a fistula after the placement of the tube. The catheter is introduced through the needle and sutured to the jejunal wall with a purse-string suture. Finally, the jejunum is attached to the peritoneal lining with sutures. Tube feeds can be started soon after surgery, within 6-12 hours. Some societies use Oxford Academic personal accounts to provide access to their members. See below. The cliniciancoordinates and directs the care related to enteral feeding. The clinician determines the optimal feeding regimen for the patient.A nutrition nursespecialist is primarily responsible for educating the patient on using the feeding tube. The nurse also supervises the care of the tube and notifies the clinician if any complications develop.The dietician manages the evaluation of the nutritional requirements, including the calculation of the daily caloric need and the optimal fluid requirements.The pharmacist provides the enteral feed and can mix and compounds parenteral nutrition. The pharmacist advises on the compatibility of nutrients and interaction.Other ancillary staff includesthe social worker, physical, occupational and speech therapists, and a case manager to help arrange home supplies. [64] Enteral nutrition uses the gastrointestinal tract to supply nutrients. This can be accomplished by feeding by mouth or through a feeding tube.

Should there be any dispute as to the position of the tube, do not recommence feeds. Discuss with senior nursing staff or medical staff. Turgay, A S., & Khorshid, L. 2010. Effectiveness of the auscultatory and pH methods in predicting feeding tube placement, Journal of Clinical Nursing, 19, pg 1553-1559. Enteral feeding is a method of supplying nutrients directly into the gastrointestinal tract. This guideline will use this term describe Orogastric, Nasogastric and Gastrostomy tube feeding. A wide range of children may require enteral feeding either for a short or long period of time for a variety of reasons including: Feeds can be administered via syringe, gravity feeding set or feeding pump. The method selected is dependent of the nature of the feed and clinical status of the child. There is limited evidence available to support one method of feeding over the other.Trans-Anastomotic Tube (TAT tube) - Utilised after surgery to repair oesophageal atresia inserted by surgeons in the Neonatal patient population. Liesje Nieman Carney, RD, CSP, LDN, is a Publication Specialist/Clinical Dietitian IV at The Childrens Hospital of Philadelphia. A nationally recognized expert in clinical pediatric nutrition, she has been extensively published in peer-reviewed journals and textbooks. Ms. Carney has held leadership roles in the Pediatric Nutrition Practice Group of the Academy of Nutrition and Dietetics and in ASPEN. Consider gastric venting – release gas by attaching an open-ended large syringe to the feeding tube. Continuous venting may be facilitated following administration by securing the distal end of the tube above the head of the child. This may be attached to the end of a 5 or 10mL enteral/oral syringe with the plunger removed to create a reservoir should gastric contents reflux This is one of the most common reasons for admission into the intensive care unit (ICU). Daily protein intake should be around 1 to 1.8 g/kg daily. Use of high fat, low carbohydrate is not indicated. ALI and ARDS require an enteral diet rich in omega-3 fatty acids and antioxidants. [16]

The feeding tube passes through the anterior abdominal wall into the gastric cavity. A gastrostomy tube is utilized for patients who require long-term feeding. It can be placed via endoscopy percutaneous endoscopic gastrostomy (PEG). [24] [25]PEG tubes are for patients who require long-term nutritional support. PEG tube with jejunal extensionis associated with tube dislocation and dysfunction. [25]A gastrostomy feeding tube can also be placed radiologically, surgically, or via endoscopy. [26] Crushing tablets and opening capsules should only be considered as a last resort, because of potential dosing inaccuracies, occupational exposure and increased dose preparation time. Thiamine, riboflavin, folic acid, andpyridoxine should be supplemented, including fat-soluble vitamins A, D, E, and K. This method is used for patients in a semi-recumbent position. Enteral feeding is delivered via a pump or gravity. Enteral feedings are delivered over an 8- to 16-hour period. This is the most gastrointestinal complication seen in enteral feeding. Diarrhea occurs in about 30% of patients admitted to the medical or surgical wards and about 80% of patients in the ICU. [28] [34] [35]This article provides some information on the factors for consideration and their possible affect on medicines being administered via enteral feeding tubes. Factors affecting medicines administration Do not administer feeds through enteral tubes that are being used for aspiration or are on free drainage.