HINT: What is new and different with enteral tubes?

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.

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HINT:  What is new and different with enteral tubes?

SITUATION: 

This QuickHit was informed by the upcoming change of all enteral supplies to the ENFit brand at SickKids for children in hospital and in transition to home and community.

BACKGROUND:

Many children with medical complexity rely on enteral feeding tubes to support nutrition, hydration, and/or medication administration. Some enteral supplies run the risk of being connected to other devices and tubing (e.g., IV tubing).

ENFit includes a new type of connection port for enteral feeding products and accessories as shown in the image below. It has been designed to ensure that enteral devices cannot be connected to other medical devices to prevent serious safety events.

ASSESSMENT:

Current enteral feeding supplies will be updated to the new ENFit supplies including feeding tubes (NG and G tubes), feeding bags and syringes, medication syringes, and associated accessories. The following images demonstrate many of the new ENFit enteral feeding supplies and accessories 

FEEDING TUBES

Nasogastric Tubes

G Tubes

FEEDING BAGS

SYRINGES

ADAPTORS AND ACCESSORIES

RECOMMENDATION:

Connected Care recommends the following when transitioning to using ENFit enteral supplies for children in home and community settings:

1. When connecting ENFit products, complete one turn to secure. Avoid overtightening connections as this can make it difficult to disconnect.

2. The ‘moat’ or the open area of the end of the feeding tube can collect excess feeds, medication, and debris (see image below). Use an interdental tool to clean daily or more frequently as needed.

3. Medications prepared with ENFit syringes are drawn up using an ENFit cap, press in adaptor or straw. This reduces the risk of contamination and the amount of medication that collects in the moat of the syringe.

4. When priming feeding bags, prime only to the proximal end of the connector to prevent accumulation of feed in the moat of the feeding tube.

5. ENFit products can be connected to non-ENFit products using a white Christmas tree adaptor. In addition, non-ENFit products can be connected to ENFit products using a purple AMT adaptor.

6. Review the AboutKidsHealth article that reviews how to use ENFit enteral feeding supplies

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At this time, Connected Care Live is limited to home and community care nurses and pre-registered family caregivers, and is not to be used in the event of an emergency.

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