ALERT: How to replace a broken Y adaptor on an ENFit Corflo PEG gastrostomy tube?
Connected Care Quick Hits are up to date and evidence based recommendations for the care of children with medical complexity & technology dependence, from hospital to home.
ALERT: How to replace a broken Y adaptor on an ENFit Corflo PEG gastrostomy tube?
SITUATION:
This QuickHit was informed by recent Connected Care Live consults from family caregivers requiring support for managing broken adaptors on ENFit Corflo PEG gastrostomy (G) tubes at home.
BACKGROUND:
Many children with medical complexity rely on enteral feeding tubes to support nutrition, hydration, and/or medication administration. Recently, SickKids and other hospitals have transitioned all feeding tube supplies and accessories to a new global standard called ENFit. ENFit is a new and safer design for feeding tube connectors because it cannot be connected by mistake with other medical devices or equipment (e.g., IV tubing).
With this transition, there has been an increase in the number of reports of broken and/or leaking ENFit Corflo PEG Y adaptors from family caregivers in home and community settings. In addition to this, the replacement Y adaptors are on backorder at SickKids and many other vendors within Ontario.
ASSESSMENT:
Corflo PEG is a type of G tube that is often inserted as a child’s primary G tube. Corflo PEG tubes have the following components:
Y adaptor: Used for feeding and medication administration
Clamp: Prevents backflow from the stomach when the tube is not in use
Crossbar: Sits on the abdomen and prevents the tube from migrating into the stomach
Round bolster: Located inside of the stomach to prevent the tube from being dislodged
Since the transition to ENFit, family caregivers have reported breakages in the Y adaptor of their child’s Corflo PEG tube. In most cases, the breakages have been identified in the location outlined in the image below. These breakages have resulted in leakage of feeds and medications and in some cases the tube can no longer be used.
RECOMMENDATION:
Connected Care, in collaboration with the G Tube team at SickKids, recommends the following to replace a broken Y adaptor on an ENFit Corflo PEG tube:
For minor cracks or breakages, cover the broken area using waterproof tape (e.g., Leukoplast) as a temporary solution. Monitor the tube closely for leaking of feeds and medications.
Replace the broken Corflo PEG Y adaptor with a new Y adaptor, if available. The following AboutKidsHealth video provides step-by-step instructions on how to replace the Y adaptor. Please note that there are backorders on ENFit Corflo PEG Y adaptors at SickKids and enteral feeding vendors across Ontario.
If a new ENFit Corflo PEG Y adaptor is not available, select one of the following recommended options for replacing the broken Y adaptor:
Option 1: Remove the broken Y adaptor and replace it with a white pine tree adaptor and Kangaroo Y extension set (see image below). Consider taping the connection area for extra securement.
Option 2: Remove the broken Y adaptor and replace it with a Kangaroo ENFit Y Port PEG adaptor (see image below). Consider taping the connection area for extra securement
4.Contact your child’s G tube specialist for follow-up and additional support, if needed. Enteral feeding supplies are available for purchase at the Specialty Food Shop at SickKids. Note supply chains may affect timely access to some supplies.
5.Review the Connected Care Quick Hits on caring for a child with an ENFit enteral tube:
For more information about heparin locking consult Connected Care Live and click here for more information from AboutKidsHealth
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