HINT: Do you know what type of enteral feeding tube the child has?

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: Do you know what type of enteral feeding tube the child has?

SITUATION: 

This QuickHit is informed by the G-tube Team at SickKids. They find that misidentification and inaccurate documentation of enteral tubes can lead to serious safety events or potential harm.

BACKGROUND:

Many children with medical complexity rely on enteral feeding tubes to support nutrition and/or medication administration. Increased enteral tube options for children create challenges in accurate identification of the type of tube. The home care and best practice in caring for a child's enteral tube depends on reliable documentation and management of the unique features of each tube.

ASSESSMENT:

To safely manage a child's tube it is important to know:

• What type of tube it is (including brand name)?

• What is the French (Fr) size of the tube?

• Who put the tube in (Image Guided Therapy or General Surgery)?

• When it was inserted (initial creation of the stoma)?

The types of tubes are typically named based on where in the body they are inserted and whether the tube accesses the stomach or the jejunum. The photos below are examples of common brands of each type of tube. There are many additional brands not shown here.

Types of Enteral Tubes include:

Gastrostomy (G) tube: is inserted into the stomach through the abdominal wall

Gastrojejunostomy (GJ) tube: is inserted through the abdominal wall, into the stomach, past the pylorus and into the small bowel (jejunum)

Gastrostomy/Gastrojejunostomy (Combination G/GJ) tube: is inserted through the abdominal wall, into the stomach, past the pylorus and into the small bowel (jejunum). Both the stomach and jejunum can be accessed with these tubes

Jejunal Tube (J) tube: is inserted directly into the jejunum by a General Surgeon

RECOMMENDATION:

Appropriate identification of enteral feeding tubes is essential to providing safe and consistent care for children who depend on them.

Connected Care suggests:

• Make it a habit to clarify and confirm the type of tube before each use

• Establish where the tube type is documented and update it accordingly

• If there is a discrepancy or you are unsure, do NOT use the tube until verified

If you are unsure about a child's tube type, consider:

• Ask the child's family caregiver

• Refer to the resources on the Tube Feeding Learning Hub

• Contact the G-tube Nursing Team (during regular business hours)

• Make a Connected Care Live Consult 24/7

The G-tube Feeding Program at SickKids is hosting Feeding Tube Awareness Week - February 8-12, 2021