In the UK, procedure-related morbidity is thought to be 9-17% and mortality 0.5% (NPSA, 2010); 30 days post-procedure mortality rates are 4-26% (Tanswell et al, 2007). Of these, there were 11 deaths and 11 incidences of severe harm resulting in emergency surgery or high dependency unit/intensive therapy unit admission. Look at the area where the tube enters the skin. If the decision is made to proceed with PEG tube placement, prior to the procedure the patient’s bloods must be closely monitored for signs of abnormal coagulation and infection, and clinical observations monitored. If flushing causes pain it should be stopped and the medical team informed immediately as this is a red-flag alert and needs urgent attention. Definitions: PEG: A percutaneous endoscopic gastronomy (PEG) tube is used to deliver nutrition, hydration and medicines into the individual’s stomach. Remove old dressing (if dressing is being used). Care of your PEG tube and skin Use a clean cloth and tap water to wash around your PEG tube. Be able to open their mouth to at least 3cm to allow mouthguard placement; Be able to lie flat for approximately 20 minutes for the duration of the procedure; Be on no more than minimal oxygen therapy; Have blood coagulation within the normal range. There is an adaptor at the external end of the tube to fit specific enteral syringes and feed-giving sets. You have discomfort or pain around your PEG tube site. The external part of the tube has an adjustable fixation plate commonly made from soft silicone. Select one or more newsletters to continue. A mouthguard is put in their mouth to prevent them biting the endoscope and to protect their teeth. Continuous feedings run all the time. Wash your hands with soap and water before and after care. Once the endoscopist can see the trocar in the stomach, the metal needle is removed leaving the open-ended sheath in the fistula tract (Fig 3). The tube should then be flushed with 50ml of sterile water. 6-8 weeks for tubes/ buttons in which the stomach was sutured to the abdominal wall . Check the tube exit site for skin irritation, inflammation, or other signs of infection, gastric leakage, or formula leakage. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health. Healthcare providers will teach you how to put liquid food and certain medicines through the tube. As the needle is retracted, anaesthetic is injected to anaesthetise the layers of the abdominal wall (Fig 2). Data sources include IBM Watson Micromedex (updated 7 Dec 2020), Cerner Multum™ (updated 4 Dec 2020), ASHP (updated 3 Dec 2020) and others. The tube is kept in position by being held between a mushroom shaped retention flange in the stomach and a … The patient is usually endoscoped again to check the position of the retention bumper. 99 ($1.50/Count) Save more with Subscribe & Save. This route is generally used fo… The patient’s doctor must be informed of any concerns as soon as possible so management plans can be initiated, and referral made to relevant members of the multidisciplinary team. It goes directly into the stomach. Author: Sharlene Haywood is clinical nurse specialist nutrition support, Royal Free London Foundation Trust. A trocar (metal needle encased by a plastic sheath) is inserted into the incision to create the fistula tract from the abdominal wall to anterior gastric wall. The NPSA (2010) developed “red-flag” alerts to initiate immediate reaction to serious complications post PEG tube insertion. Failure to comply may result in legal action. $17.99 $ 17. Tube is then secured in place. We comply with the HONcode standard for trustworthy health information -. To ensure proper measurement tube should be measured from the tip of nose to the ear lobe to 1 inch below the xiphoid process. Nursing Times [online]; 108: 42, 20-22. 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