Care Instructions AMT G-JET

Transcription

1 Care Instructions AMT G-JET Patient name Date of Insertion Conversion Primary Placement The device size is: FR G CM J CM Balloon Fill Volume: ml Safe to gastric feed Y N

2 Useful numbers Professional Name Telephone number Ward Consultant Surgeon Dietitian Nurse Specialist Community Nurse Local Hospital Community Dietitian Local Paediatrician GP Health Visitor School School Nurse Home Care Company The AMT G-JET The AMT G-Jet is a triple lumen feeding device which is used to help patients meet their nutritional needs by feeding directly into the small bowel whilst being Gastric venting port (attach white extension set) Retention Balloon In order to feed give, medication, or vent from the AMT G-Jet, a feeding/ venting set needs to be attached. Jejunal feeding port (attach beige or luminous extension set here) Balloon Inflation Port There are a variety available to suit patients needs. If both ports are used at the same time attach the venting set into the G-port first.

3 Care and use of the AMT G-JET Wash hands before and after carrying out any activity with the tube. Bathing and showering are the easiest way to keep the skin underneath the tube clean. Make sure the skin is dried well. Dressings are not required unless advised by health care professional. The water in the retention balloon should be checked once per week with the recommended fill volume (written on top of the balloon port). If the water is less than the recommended volume re-inflate with the correct amount. DO NOT remove the tube at this point. Re-inflate with fresh (sterile water or cooled boiled water as advised by your local health care professional) DO NOT ROTATE the tube as this can kink or displace the tube. The patient can swim and partake in all physical activities once the stoma has healed (usually 3-4 weeks after initial placement). Gastric Venting Sets The end which attaches to the G-port should be white. The code on the packaging has to start with 6- Jejunal Feeding Sets The end which attaches to the J-port should be beige or luminous. The code on the packaging has to start with 8-

4 Feeding/Venting Attach the Jejunal feeding or Gastric venting sets by lining up the dark line on the feed set or venting set with the dark line on either the Jejunal feeding port or the Gastric venting port and rotate 3/4 clockwise to lock into place, until you meet resistance. Do not rotate any further as you will cause damage to the AMT G-Jet. The feeding/venting sets need to be cleaned after each use by rinsing with mild soapy water and re-rinse thoroughly with water. After washing, allow them to air dry. (Follow directios as per local guidelines) Store in a clean dry container with the clamp left open. Feeding/venting sets can be used for up to 2 weeks providing they are adequately cleaned in between usage (follow directions as per local guidelines) Ensure you inform your supplier in plenty of time when new sets are required. Continuous feeds into the Jejunum must be given via a pump, the tube must be flushed at least 3 times a day to prevent any blockage. If feeds are being given, the tube must be flushed before and after feeds to prevent blocking. The patient should ideally be positioned at a minimum of 30 degrees for feeds. When giving medication either into the gastric port or the jejunal port (as advised by your healthcare professional) it should be given in liquid form and the port used should be flushed after administration, If cruched or dispersible tablets are given, extra care should be taken that the set is flushed well between and after each medication to prevent blockage using a start and stop flush technique (as advised by your healthcare professional)

5 Problems that may arise Tube Blockage To prevent tube blockage, flush the tube (as per feeding plan) Before and after each feed Before and after giving medications If a specialist has instructed otherwise, follow your specialist s instructions. Do not mix medicine with formula. Medication should be taken in liquid form when possible. If not, crush finely and make sure it is well dissolved in water. Give multiple medications one at a time and flush the tube between each medication. Leakage Leakage from the button can occur from the feeding port or around the tube. If there is leakage from the feeding port the button might need to be flushed with warm water to clean debris from underneath the valve. If leakage occurs around the tube check the balloon fill volume is as recommended. If volume is less replace the amount. Leakage that continues for a long period of time may indicate that the tube needs to be replaced. Balloon Rupture If the balloon bursts it is important that the tube is replaced. Tape the tube in place to stop it from falling out and contact the hospital where the tube was placed immediately. Stoma problems Contact your healthcare professional if: There is some extra shiny pink tissue around the stoma site The gastrostomy site seems persistently red or is bleeding, oozing, irritated or swollen The gastrostomy site emits an odour There is pus around the stoma site If there are leaks of fluid around the gastrostomy tube, OR pain on feeding OR new bleeding, OR the tube falls out, stop feed immediately and telephone for urgent advice.

6 Check list To be completed to ensure that parents and carers have been taught the appropriate skills, and have been given the appropriate information for them to care for the patients AMT G-JET tube. Patient s name Date of Birth Date training commenced AMT G-JET teaching (Care of tube) Hand hygiene Demonstrate AMT G-JET Use of feeding set Jejunal Port Use of venting set Gastric Port Care of site Flushing tube Testing tube position Giving medication Following feeding regime Winding Safety pack & extension set given Oral hygiene/stimulation Discussion or demonstration by nursing staff Parents and carers are confident in delivering care Please sign and date each section as completed Areas to be discussed Problems related to stoma site Problems related to tube and feeding Daily living activities Tick when discussed Redness Leakage Over granulation Blocked tube Tube falls out Position of tube Swimming

7 Next Tube Change Due/Planned Record of when tube changed and why Date Why changed and size Inserted Notes

8 T: +44 (0) Support groups and websites PINNT (Patients on Intravenous and Nasogastric Nutrition Therapy) PO Box 3126, Christchurch, Dorset, BH23 2XS Tel: Website: Contact a Family City Road, London, EC1V 1JN Tel: Fax: Helpline or Textphone Freephone for parents and families (10am-4pm, Mon-Fri) info@cafamily.org.uk TOFS St. George s Centre, 91 Victoria Road, Netherfield, Nottingham, NG4 2NN Tel: +44 (0) Fax: +44 (0) For all general enquiries: info@tofs.org.uk Website: G-Jet is a Trademark of Applied Medical Technology Inc. T: +44 (0) F: +44 (0) info@gbukenteral.com GBUK Enteral Ltd, Blackwood Hall Business Park, North Duffield, Selby, North Yorkshire, YO8 5DD This publication was designed and printed by: GBUK Enteral LTD Enteral UK is a trading name of GBUK Enteral Ltd Copyright 2013 ENT113