Assisting in Gastrostomy Feeding

Assisting patient with a Gastrostomy Feeding.

Equipment:
     Feeding solution
     Graduated containers
     Large syringe (60ml catheter tip)
     Reservoir bag with tubing and regular clamp
     50ml water
     4x4 gauze sponge
     towel/linen saver
     stethoscope
     tape measure
     Adapter to connect tubing
     Sterile basin

Optional: infusion controller pump and tubing set for continuous feeding infusion




Preparatory phase:

1. Explain procedure to the patient. Give the patient a schedule of subsequent feedings if he is on intermittent feeding.

2. Administer the feeding at room temperature. Do not heat the formula, as heat could curdle the feeding solution, change the nutrients, or burn the patient.

3. Using clean technique, measure the prescribe amount of feeding solution into graduated container.

4. Pour 50ml of water into graduated container.

5. Remove air from the tubing by slowly opening the clamp.


Procedure:

1. Provide privacy. Protect the patient from spillage.

2. Elevate the head of the bed 30-45 degrees during infusion of feeding stops. This prevents aspiration by gastroesophageal reflux and also facilitates digestion.

3. Remove the cap, plug or clamp from the patient's gastrostomy tube.

4. Using a syringe, gently aspirate the stomach contents before each feeding. A residual of 100ml or more indicates delayed gastric emptying. Vomiting may occur and stomach becomes distended.

5. Connect the reservoir bag tubing to the gastrostomy tube. If a catheter tip is used, remove plunger and attach syringe to pinched off end of feeding tube. Pinching the feeding tube will prevent excess air from entering the stomach which causes distention.

6. If an  infusion controller pump is used, purge the air from the tubing according to manufacturer's directions. Attach controller tubing to gastrostomy tube. Open the regulator clamp and adjust the flow rate. This verifies true patency, moistens the tubing and prevents feeding solution from adhering to tubing.

7. If using a syringe, fill the syringe with feeding solution and release the feeding tube. When the syringe is almost empty, refill with the feeding solution. Do not allow air to enter the syringe. Never allow syringe to empty completely.

8. Administer feeding slowly, usually 200-350ml over 10-15 minutes period.

9. Flush the tubing with 20-50ml of water after administering prescribed amount of feeding. Clearing the tubing of solution maintains the patency.

10. Depending on the equipment use, turn off the infusion controller; or, disconnect the syringe from the gastrostomy tube. Close the regulator clamp on the reservoir bag.

11. Cover the end of the feeding tube with a plug or cap and wrap it in a gauze secured with a rubber band to prevent leakage and contamination.

12. Twist the thin strip of adhesive around the gastrostomy tube and attach firmly to abdomen, or coil in a dressing.

13. Allow patient to remain in a modified upright position for at least 30-45 minutes. This helps prevents regurgitation, pulmonary aspiration and also aids in digestion.

14. Rinse reusable equipment with water. Dry.

15. Document date, time of feeding started and ended, type and amount of feeding solution administered; and the amount of water used. Record patient's tolerance to gastrostomy feeding. Record drugs given through the tube. Record and report cramping, abdominal distention, and diarrhea. Note results of laboratory tests.