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.
Contact
Ward J91 at SJUH
Skin care and tube position
Never give a feed if you are unsure of your tube position.
For the first 7 days after insertion, clean your PEG tube site with cooled, boiled water. After 7 days, you can use warm, soapy water.
After cleaning, always dry gently. Make sure the fixation plate is sitting against your skin (approximately ½ cm away from the entry site) and if possible, secure your tube above the entry site to prevent the tube from dragging downwards.
If the fixation plate looks and feels too tight, it should be adjusted. If you have not been shown how to do this, contact your enteral feeding company or community nurse for assistance.
Avoid using cotton wool, talcum powder or creams on your site.
If you have any signs of swelling, redness, odour or irritations, contact your community nurse, enteral feeding company nurse or dietitian for advice. Some clear discharge may be present, this is normal.
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Always wash your hands before touching your feeding tube or gastrostomy site.
You do not need to check the position of your feeding tube regularly; however, if you have any concerns about the position of your tube, ask your enteral feeding company nurse to show you how to check the tube position using pH paper.
Tube care – advancing and rotating
Once your tube has been in place for 2 weeks, there are a couple of extra things you need to do to keep the tube working well. Your enteral feeding company or community nurse will support you with all of this.
- The tube needs to be rotated around 360 degrees every day.
- The tube needs to be pushed inside the stomach just a couple of centimeters and rotated 360 degrees once per week.
It is good to leave the clamp open when the tube is not in use; however, if you choose to clamp the tube, you should change the position of the clamp daily to prevent damaging your feeding tube. If the clamp becomes loose, you can ask your enteral feeding company nurse for a replacement.
The end of your feeding tube (the part that attaches to the syringes and feeding sets) can get worn and collect feed and medications; therefore, it is important you clean this at least once per week with warm water. The end of the feeding tube will routinely be changed every 12 weeks and you will be provided with a spare end.
Positioning during feeding
When you are feeding, particularly during the night, ensure you are propped up with pillows. A position of 45 degrees will allow the liquid feed to move out of your stomach properly, reducing the chance of you being sick.
What to do if my tube falls out
In the unlikely event your tube falls out, contact your community or enteral feeding company nurse as soon as possible and locate your spare balloon gastrostomy tube (this should have been provided with your first delivery). The nurses may need to use the spare tube. You should always take this tube with you if you are away from home for long periods of time (e.g. holidays). If you are unable to reach your community team, please call J91 using the contact details at the beginning of this booklet.
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