Canadian Society for Clinical Nutrition

1
Canadian Society for Clinical Nutrition

• Enteral Access Devices
• Presented by
• Bonnie Bachinsky,RN
• RN contacts RD contacts
• bbachins_at_cha.ab.ca sgosse_at_cha.ab.ca
• sboudrea_at_cha.ab.ca lkaiser_at_cha.ab.ca

2
Northern Alberta Home Nutrition Support Program

• Outline
• Long-term enteral access devices (not NG/NJ
  tubes)
• Site care
• Granulation tissue
• Infected sites

3
Northern Alberta Home Nutrition Support Program

• Patients
• at home on enteral feeds
• Northern Alberta
• have a tube
• gt18 yrs

4
PEG (percutaneous endoscopic gastrostomy)

• Loosen stabilization bar
• Rotate 360º daily

5
PEG Site Necrosis

• Antibiotics via tube
• Proton Pump Inhibitor
• Absorbent dressing
• Skin barrier

6
PEG-J(percutaneous endoscopic gastrostomy-jejunos
tomy)

• time consuming to place
• easily displaced and plugged

7
Surgically Placed Tube

• Foley, Malecot, others
• Latex
• Suture

8
Radiologically Placed Tubes

• White with red end
• 12 and 14F
• G, J or G-J-tube

9
Balloon/Replacement Tubes

• identify by balloon port
• G-tubes - 5-7cc water in balloon
• J-tubes - 3 cc water in balloon

10
Skin Level Device/Replacement Tubes
11
Skin Level Device/Replacement Tubes

• Mic Key
• Sizing
• Extension sets

12
Skin Level Device/Replacement Tubes

• Bard Button
• Obturator
• Extension sets

13
Skin Level Device/Replacement Tubes

• EntriStar
• GripStar
• Extension Sets

14
Site Care

• Cleaning with water daily
• Showers, bathing
• Routine use of antibiotic cream
• Other cleansers

15
Granulation Tissue

• Silver nitrate
• Foam dressing

16
Infected Site

• Hot, red, exudate
• Liquid antibiotic via tube

17
Infected Site

• Tube too short
• Culture

18
Chemical Burn

• Not infected
• Burn from gastric drainage